CHICAGO -- The big topic at the American Medical
Association's annual meeting this summer was not Michael Moore's �Sicko� but
the AMA's siccing drug salesmen on doctors by selling its database.
By selling the names, office addresses and practice types of
almost every doctor in the US to marketing firms, the AMA makes $50 million a
year, charged the National Physicians Alliance, American Medical Student
Association and Prescription Project which protested at the Chicago convention.
The AMA database, called the Physician Masterfile, is used
by Health Information Organizations (HIOs) for data mining and detailing which
reveals individual doctors' prescribing profiles to help drug salesmen.
Information about more than 900,000 physicians is included
in the AMA data-selling scheme, two-thirds of whom are not even members of the
"The pharmaceutical industry's practice of marketing
drugs to doctors by creating prescriber profiles intrudes into the private
doctor-patient relationship and affects the quality of patient care while
driving up the cost of healthcare," said National Physicians Alliance
President Lydia Vaias, MD.
"Doctors are not aware that companies are out there
that know every prescription a doctor prescribes," added Dr. John Santa,
an internist at the Portland Veterans Affairs Medical Center working with the
Prescription Project, a coalition to curb drug companies' access to doctor
Forty percent of doctors surveyed by the Kaiser Family
Foundation were unaware of the data sales and once told, 74 percent
Last year, the AMA attempted to stop states from banning
such doctor data sales -- Vermont just restricted the practice and Maine might
be next -- by self-policing and creating a Physician Data Restriction Program
(PDRP) which lets doctors "opt out" of having their data sold. So
far, 8,000 have done so.
But why should the opting out burden be on doctors, some of
whom have never heard of the program and/or don't belong to the AMA (which
requires those opting out to register on the site) ask Prescription Project
physicians who think it should be an "opt-in" program in which
doctors consent before their identifying data is sold.
In discussing the doctor data sales on its web site, the AMA
sounds like the little boy who didn't hit his brother and even if he did, it
wasn't hard, and even if it was hard, he deserved it.
First it says it doesn't sell the data -- or even have it.
Then it says it only sells the data to "prevent fraud and abuse,"
assist accreditation and help the government with national disasters
like Sept. 11 and Hurricane Katrina.
Then it says it DOES sell the data "for use by
pharmaceutical companies" but that the organizations would get it anyway.
(They "have multiple sources of physician data independent of the
THEN it says that selling the data lets the AMA "exert
regulations on how physician data are used," so it's really protecting
doctors, albeit from itself.
We're also told that selling doctor data facilitates
"efficient drug recalls," and "Food and Drug Administration's
ongoing post-approval assessment of drug benefits versus risks" -- Big
Pharma is really just a humble NGO -- and it even helped rebuild patient
records after Hurricane Katrina.
Not surprisingly, Verispan,
one of the two biggest health information organizations, also hums the National
Anthem in defending commercial use of doctor data.
"Improvements in healthcare quality, cost management
and patient safety hinge on access to more healthcare information, not
less," it says on its web site; "prescriber-level information"
significantly "contributes to patient health, safety and quality of
But doesn't a physician have the right to health care
privacy like patients?
Not necessarily. A New
Hampshire court recently ruled that NOT making such data available
violated the First Amendment rights of drug marketers.
And two years ago the AMA gave a similar nod to drug
marketer provenance when it refused to recommend a ban on prescription drug ads
because it "would violate drug makers' free-speech rights" and the
"ads have helped increase awareness and reduce stigmas about certain
disorders, including mental illness." Months earlier increased
awareness of certain disorders necessitated black box warnings on
antidepressants for children.
Protesting the data sales, Michael Ehlert, MD, president of
the American Medical Student Association, says the AMA should be a leader in
"ensuring that doctors are making prescribing choices based on science,
not marketing" and that physicians should do all they can to "combat
the presence of the pharmaceutical industry that works hard to insert itself
into important medical decisions."
But the AMA contends that sales reps perform a valuable
service by helping to get "public health and education to the right
doctors when new products or devices have come on the market." Funny
that's what the Merck ad on the AMA web site says too.
Martha Rosenberg is a Staff Cartoonist at the Evanston
Roundtable. Her work has appeared in the Chicago Tribune, LA Times, San
Francisco Chronicle, Boston Globe, Providence Journal. Arizona Republic, New
Orleans Times-Picayune and other newspapers. She can be reached at: email@example.com.