Linda Lewis says that when she had back surgery two years ago, her surgeon didn't do what was best for her health; he did was best for his bank account.
If Linda Lewis had known of her surgeon's financial ties to a device maker, she'd have sought a second opinion.
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How likely is it that your doctor has a tie to a company that makes drugs or devices? Very likely, according to Dr. Robert Steinbrook, who wrote an article on doctor/industry ties this month in the
New England Journal of Medicine.
"Most physicians in the United States have financial relationships with industry, ranging from the acceptance of meals to the receipt of large sums of money for consulting, speaking, or conducting research," he wrote.
For example, two physicians made more than $8 million each from Dupuy Orthopaedics Inc., which lists the payments on its Web site.
"Consumers should absolutely know where their doctor is coming from," said Steven Findlay, a health care analyst at Consumers Union. "Doctors think they won't be influenced by these financial relationships, but the research shows that they are."
Eric Campbell, an associate professor of health policy at Harvard Medical School, put it a different way.
"Let's say your investment counselor went on a trip to Aruba paid for by a certain company," he said. "Then he comes home and recommends you invest in that company. Wouldn't you be concerned?"
If you want to know whether your doctor has financial ties to industry, and how that might color his or her treatment recommendations, experts have this advice:
1. Pens, pamphlets and attractive people in suits
"Look around for hints that your doctor sees a lot of drug reps," advised Dr. Daniel Carlat, an assistant clinical professor of psychiatry at Tufts University Medical Center who
blogs about the industry's influence on physicians.
If you want to know whether your doctor has been influenced by industry sales people, Carlat advises patients to look for anything branded with a drug company's name, such as pens and pamphlets.
"And if you see an extremely attractive, impeccably dressed, polite person with a briefcase in the waiting room, watch out! That's most likely a drug rep," he said.
2. Ask questions about devices
Device companies -- those that make heart stents, for example, or artificial knees -- spend millions on fees to physicians.
If you're considering getting an artificial knee or hip, you can check with the
Association for Medical Ethics to see whether your doctor has a financial tie to Dupuy Orthopaedics or Zimmer Inc., Biomet Inc., Smith & Nephew Inc. or Stryker Orthopedics. All were required last year by the U.S. Department of Justice to disclose consulting agreements with physicians.
3. Ask questions about drugs you'll take long-term
Brand-name drugs taken long-term -- antidepressants, for example, or cholesterol drugs -- are often heavily marketed to physicians.
If you're suspicious that your doctor's prescription might be based on ties to a certain company rather than on your health, you can ask questions.
"Ask the doctor what's the scientific evidence for prescribing that particular drug over another one. They must have a scientific reason, especially if it's a high-price brand-name drug instead of a generic," Campbell said.
4. Know when not to worry
Is it worth trying to figure out whether every prescription is based on a tie to a pharmaceutical company?
"There are circumstances where you want to take this extra step, and there are other times where you really don't want to bother," Findlay said.
For example, Findlay says, pharmaceutical companies usually don't heavily market antibiotics; they're taken for short periods of time and aren't usually huge money-makers.
The American Medical Association stresses the need for disclosure of doctor-drug company relationships. "The first priority of physicians is the health and well-being of our patients," said Joseph Heyman, M.D., the AMA's board chair.
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onder: Another good book that talks about this and is written by a dr. at Harvard is "Overdosed America", by John Abramson.