Friday, November 18, 2011

Dollars for Docs Discussion

First, I want to acknowledge Ellen Ullman (@CureT1Diabetes) who tipped me off to this event on Google+. Although I might have enjoyed the opportunity to attend this in person and ask questions of the presenters, alas, I had other plans that evening.

My readers may recall that earlier this year (on Valentines Day, no less!), I wrote a post (see HERE) about a new database that was assembled by ProPublica, which is a non-profit corporation based in NYC. ProPublica describes itself as "an independent non-profit newsroom that produces investigative journalism in the public interest". That database is known as Dollars for Docs.

ProPublica senior reporters Charles Ornstein and Tracy Weber, both past winners of the Pulitzer Prize, are the lead reporters on the Dollars for Docs project that examined how pharmaceutical company payments to doctors for consulting, speaking, research and other expenses can have undue influence on the drugs they prescribe to patients. This was a discussion with someone else whose opinion I respect, specifically former editor of the New England Journal of Medicine and author of "The Truth About the Drug Companies", Dr. Patricia Angell. My readers may recall that I've quoted her from a 2007 editorial she wrote for the Boston Globe (see for that) entitled "Taking back the FDA" about how much of the FDA and much of its staff are now indirectly on the payroll for the very industries it is supposed to be regulating. In this video, Dr. Angell speaks with ProPublica senior reporters Ornstein and Weber.

In my opininion, the biggest and most important component of this research was the development of a searchable database that shows over $760 million worth of payments from pharma companies to doctors. Dr. Angell, who teaches in Harvard's Division of Medical Ethics, also wrote a book that explains how "Big Pharma" uses much of their revenue for big marketing campaigns instead of research and development.

In the following video, the trio talk about why pharma makes payments to doctors, whether the new healthcare law might help make these payments more transparent, what patients should ask their doctors about their prescriptions, and who benefits most in the end. I would just paraphrase a relevant paragraph from my original post covering the Dollars for Docs database post that's worth repeating:

Under the new U.S. healthcare law, starting in 2013 [that's next year!], ALL drug/biotech/medical device companies selling products in the U.S. will be required to disclose this data in a public database to be operated by the U.S. Department of Health and Human Services. Let's just call the Propublica "Dollars for Docs" database a sneak peek at what we're likely to see much more of in the next few years.

However, there are legal challenges to portions of this landmark legislation (the healthcare law), and it's popular in some circles to talk about dismantling it, but it's clear that it's not going away anytime soon, even while 26 states try to challenge the law and the federal government. In fact, earlier this week, The New York Times published an infomative article (see which indicated that although the U.S. Supreme Court agreed to hear a challenge to the 2010 healthcare law, it only agreed to hear appeals from just one decision, which was from the U.S. Court of Appeals for the 11th Circuit in Atlanta, which was the only one so far that struck down the so-called "individual mandate" which obliges everyone to purchase healthcare insurance. The appeals court went no further, severing the individual mandate from the rest of the law, at least for the moment.

Sidenote (you can skip the next 2 paragraphs if you're pressed for time):

This ProPublica discussion with Dr. Patricia Angell took place earlier this week, on Tuesday, November 8, 2011 at 6:30 pm EST in a former tenament that was restored as a museum and public space on Manhattan's (NYC) Lower East Side. The Lower East Side of Manhattan has, in recent years. become a pricey neighborhood (in fact, most of Manhattan is pricey these days, with former areas that were as recently as the 1990's considered, shall we say, dicey becoming playgrounds for the wealthy, complete with the neighborhood's own Whole Foods Market and everything). In other words, the area has gone from dicey to pricey, but was once a storied area of how immigrants once lived in cramped tenements – today's immigrants are more likely to live in places like the Bronx, Queens, parts of Brooklyn as well as parts of Northern New Jersey, having been completely priced out of Manhattan. We may like to think that things are much better for immigrants today, but things aren't really much different today, rather, they have changed form.

Today's immigrants to New York City often live in what appears to be regular housing (such as the rows and rows of two-family homes that characterize the Borough of Queens), but a growing amount of housing stock in these areas has been carved up illegally, which is a big concern in the area I live. I see many old homes around me with an unbelievable number of tenants living there, often with children. In effect, the buyers of these properties have created one or more additional dwelling units within a home without first receiving the approval of, and permits from, the NYC Department of Buildings. Some were formerly 2 family homes have been illegally converted into spaces that now are home to three or more families (see HERE for more). I think of this and compare it to a "whack-a-mole" where you hit one that pops up, and as soon as you do that, another one pops up in another location. But the discussion tenements are digression, other than the tenement museum was the location where the Dollars for Docs Discussion took place.

Back to the ProPublica Dollars for Docs Video

I should forwarn you that you can actually skip ahead about 6 1/2 minutes into the video through all the obligatory introductions in order to get directly to Dr. Angell's speech and the rest of the conversation. In this video, Dr. Angell and the ProPublica producers of Dollars for Docs discussed what they found. The short link to this video can be found at

I will close by once again including access to the Dollars for Docs database HERE:

In all, I think this videocast was an informative discussion. Please, share your thoughts!

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