The Business Ethics Blog

From the NY Times: After Sanctions, Doctors Get Drug Company Pay

Summary:
The NYT story is about physicians who, despite having been sanctioned either by professional regulatory groups or by courts, continue to be employed by drug companies.

A decade ago the Minnesota Board of Medical Practice accused Dr. Faruk Abuzzahab of a “reckless, if not willful, disregard” for the welfare of 46 patients, 5 of whom died in his care or shortly afterward. The board suspended his license for seven months and restricted it for two years after that.
But Dr. Abuzzahab, a Minneapolis psychiatrist, is still overseeing the testing of drugs on patients and is being paid by pharmaceutical companies for the work. At least a dozen have paid him for research or marketing since he was disciplined.

Rant:
There is a reason why Medicine is (supposedly) a “profession,” rather than simply an “industry.” And there’s a reason why the pharmaceutical industry is (supposedly) highly-regulated.

It’s because pharmaceuticals, and health care more generally, are the kinds of products it is very, very hard for consumers to evaluate. There’s an enormous information asymmetry between the people buying and the people selling these goods and services. Such goods and services fit very poorly the model of effficient free-market transactions between fully-informed buyers and sellers. Trust is therefore essential. Setting up systems such that trust is warranted is not easy.

With regard to physicians, our solution has been to allow them to form self-regulating, self-licensing associations, groups that devise, adopt, and inculcate shared ethical values and then enforce them. Thus, patients are supposed to be able to trust doctors because doctors are part of a profession with a set of shared values that includes “putting the patient first.”

For drug companies, the solution has been to regulate them. Give the government control over what drugs are safe enough, and effective enough, to put on the market. And then further, entrust physicians with the power to act as trusted gatekeepers for the most potent drugs (i.e., prescription drugs).

I have enormous, enormous personal respect for the many physicians (and other health professionals) who work tirelessly to benefit their patients. I also have enormous respect for the many people working inside pharmaceutical companies who truly want to be part of an industry whose goal is to produce medicines to improve people’s lives. But stories like this one point to a need both for tighter self-regulation by the medical profession, and for tougher (and better funded) regulation of the pharmaceutical industry.
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Thanks to Bryn at Genethics.ca