Don't become a victim of medical marketing

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Don't become a victim of medical marketing

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By Cohen

CNN Medical Correspondent

ATLANTA, Georgia (CNN) -- 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 had known of her surgeon's financial ties to a device

maker, she'd have sought a second opinion.

, a graduate student who lives in Sherman Oaks, California, says

Dr. Regan, a surgeon in Beverly Hills, put in an artificial disc

to help relieve her lower back pain.

" He said my back would be better than ever, " said , 45. " I'm

thinking, 'Wow, disc replacement is the best thing since sliced

bread.' "

But after the surgery, says, she ended up in debilitating pain,

could walk only with the assistance of a walker and had to have a

second procedure to correct the first one.

" I couldn't take enough drugs for the pain, " she said. " Having that

surgery was the worst decision of my life. "

said she was " livid " when she later found out that Regan had

financial ties to the company that makes the disc, saying she

believes that those ties prompted Regan to recommend the disc over

other treatment options.

In an e-mail to CNN, Regan's office manager said he " is not available

for comment. "

How likely is it that your doctor has a tie to a company that makes

drugs or devices? Very likely, according to Dr. 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 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. "

, 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. 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., & 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, " 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 ph Heyman,

M.D., the AMA's board chair.

says that if she had known that Regan had financial ties to the

Charite disc, she would have sought a second opinion about her back

pain.

According to a financial conflict-of-interest disclosure released by

the North American Spine Society, Regan received " direct or indirect

remuneration " in the form of royalties, consulting fees and research

support for staff and materials from DePuy Spine, a division of

& , which makes the Charite disc.

In addition, Regan and his co-authors " acknowledge a financial

relationship " with DePuy Spine in a note in a research study they

published last year in The Spine Journal.

is a plaintiff in a lawsuit against DePuy. A company spokesman

declined to comment on the litigation but said the Charite

disc " preserves some motion and avoids pain at the donor site. "