Piercing the veil, but missing the value of medicine's industry ties

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ProPublica's Dollars for Docs database has grown richer in pharma company payments but falls short in putting context around those expenditures, say industry-side critics.

Investigative reporters at ProPublica expanded their online tool for doing doctor look-ups, adding payments for education, research and consulting reported by eight more drugmakers. It was the first update to the information since Dollars for Docs debuted last October.

Consumers can now search the database to find out whether and how much physicians have earned from any of 12 pharma companies accounting for 40% of US drug sales. Along with a list of drugs the firm sells, ProPublica displays the company's description of each payment.

“The primary purpose of our site is not to pass judgment on relationships between physicians and the industry,” said ProPublica journalist Charles Ornstein. “The primary purpose is to allow patients, in one place, to search to see whether a physician has those relationships.”

But it's not the mere existence of those ties that concerns industry. Accompanied by a ProPublica analysis of pharma spend trends, the information forms a ready news peg for journalist around the country to write about how much local doctors earn for various activities.

After the payment data were published last year, media outlets to whom the information was provided “failed to objectively portray such payments and offered minimal, if any, contextual information,” read a statement by the pro-industry Association of Clinical Researchers and Educators (ACRE), a non-profit group of medical professionals.

The resulting coverage—and quantities of headlines such as “Docs paid to talk about drugs”—served to “further sensationalize and discredit ethical and legal collaborations,” said ACRE.

“Unfortunately, when taken out of context,” added PhRMA, “publically available information about physician interactions with biopharmaceutical companies does not convey the value of these relationships, which advance science and promote high-quality patient care.”

Ornstein countered: “Look, I think that both PhRMA and ACRE may be disappointed that this is out there in a way that patients can easily search, because the websites of the individual companies can be difficult to get through and certainly, if you're a patient, to go to every company site and look up your physician is a very difficult undertaking.”

The non-profit news organization tries to display the information exactly as the companies provide it, including, for each payment, the company's own description, Ornstein said. The list of medicines, he said, is also “very useful context,” allowing patients, who see that their doctor received a payment, to also know what drugs the company markets.

Worried about more negative press, ACRE is calling on ProPublica to develop and report on safeguards designed to ensure objective, fair-balanced reporting on the ties between physicians and industry.

As far as coverage by other news outlets, “I disagree that journalists are not taking the extra step [to provide balance],” he said. “When you go and read the local stories, journalists are calling physicians to talk to them about this and give them a voice in their stories. What struck me today as I was reading the local stories, many physicians don't want to talk about this with the media.”

In ProPublica's own story, yesterday's Piercing the Veil, and in a local piece that ran in today's Boston Globe, some physicians did not return calls for comment or declined to be interviewed. Others spoke to reporters.

In an op-ed in the LA Times today, Ornstein and Tracy Weber write that it's up to patients to ask questions of their physicians and judge whether the ProPublica data matters to them.

Ornstein said he has received “dozens of emails” from patients saying the data is useful for them, and a number from patients who said they had no concerns about seeing their doctor's name on the list.

“We're not saying someone should have a concern or should not,” he continued. “We're saying if the information is out there, it should be in a format patients can use, and we hope our site actually does that.”

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