Who is paying your doctor?

Moves are afoot in the UK and elsewhere in Europe to make public the extent to which individual doctors benefit from drug industry sponsorship and consultancy fees. The idea is to enable patients to make up their own minds whether decisions about their treatment might be affected by their doctors’ commercial interests. The same is happening in the US.

And more could be on its way. In Europe, for example, medical devices companies are in discussion to follow drug companies’ lead, paving the way for a single transparency website. In the UK, the General Medical Council is considering requiring doctors to report financial conflicts of interest on its register.

These moves are part of a push for greater transparency worldwide that has been gaining pace over the past decade. Much of the impetus has come from media exposure of conflicts of interest and dubious practices, especially in the US, and a litany of multimillion dollar drug industry “corporate integrity” settlements with the US justice department.

A US Institute of Medicine study in 2009 noted that news reports, legal settlements, research studies, and institutional announcements had documented “a variety of disturbing situations that could undermine public confidence in medicine.”1 These included doctors failing to disclose substantial payments from drug companies as required by their institutions or by medical journals; settlements by companies to avoid prosecution for making illegal payments to doctors; and professional societies drafting clinical practice guidelines without disclosing industry funding or the drafters’ conflicts of interest.

“Widespread relationships with industry have created significant risks that individual and institutional financial interests may unduly influence …