JAMA study a slap in the face to physicians

AMA recently published an article with findings from a study alleging an association between free meals for physicians and an increased rate of prescribing the branded drugs discussed during a lunch or dinner meeting. Of course, it wasn’t until you got to the very end of the piece that the authors came clean and admitted that there is no actual cause-and-effect relationship present.

The news media latched onto these findings and had a field day with the study, bashing doctors as immoral creatures who will prescribe anything in exchange for a free meal.  

To paint the entire industry of physicians with such a broad brush is absurd.  I believe that the vast majority of doctors, myself included, take many steps to try and avoid even a perceived conflict of interest by patients and others. 

I prescribe what is best for my patients and is most effective, not what a free lunch or dinner suggests I prescribe. Despite what JAMA and the American Medical Association may think, my morals, values and ethical responsibility to my patients will not and cannot be compromised by a sandwich or even a prime rib dinner. To suggest so is simply ludicrous. 

I have never been bought by the pharmaceutical industry, nor will I ever be. I practice and prescribe based on clinical guidelines and outcomes data in order to provide quality care in an affordable environment, so that my patients are not bludgeoned by high costs and copays.  There are many variables to be considered in prescribing the right drug for a patient. A free meal is not one of them. 

I believe patients are my priority because I took an oath to do what is best for them, not an oath to pharmaceutical reps to make them the beneficiary of my daily struggle to keep people healthy.

The JAMA article judges physicians based on thousands of lines of unexplained data made public by the Centers for Medicare & Medicaid Services’ Open Payments program, part of the Affordable Care Act.  The researchers used this data as the basis for their so-called findings, despite the fact that the AMA has questioned the efficacy of this public data in the first place.

In my opinion, garbage data in produces garbage results out, yet they published an article damning us all in a very public forum based on this flawed data.

Ironically, this is the association that is supposed to represent and advocate for physicians. 

The AMA and JAMA should retract the article and apologize to the medical community since they admit that the data is inconclusive.  As doctors, we deal in complexities and challenges every single day. We should be able to count on our representatives to protect our backs, not stab us in them. 

George G. Ellis, Jr., MD, is an internal medicine physician practicing in Youngstown, Ohio, and chief medical advisor for Medical Economics. Do you think the study painted physicians in an unfair light? Tell us at medec@advanstar.com.