Pay to Work

I am frustrated that I cannot locate one of my own posts!  Not too long ago I continued my reporting on doctors who are given stipends, incentives, gifts and fees by drug companies.  I have written about it many times.  Here is one of them, but not the most recent.  In the most recent, I directed you to this webpage as Propublica had released actual payment numbers on doctors in such a way as to allow you or I to look up a specific person.

These are good things and they are having an impact according to a research study out of Mass General and Harvard Med School.  In this research, they asked physicians to complete a survey.  I must admit, it is hard to get a good response to surveys and researchers need large numbers in order to make associations and especially associations that can be applied to larger groups.  So - according to the popular press article I read from L. Tanner and the AP, 64% of the people sent a questionnaire responded. 

The good news is that the medical community is setting guidelines and standards and the practice of wining, dining and paying doctors is easing.

The GREAT irony is that those who completed the survey earned themselves 20 bucks. 

This triggered me to write.  I recall speaking to a room full of physicians who were receiving a catered dinner and a couple hundred bucks for coming to this once a year meeting on how to treat tobacco dependence in their patients.  Yes, we spoke to them about Best Practices - how to use this technique called the 5As - Ask, Advise, Assess, Assist, Arrange.

Another study has actually paid doctor's offices a monthly stipend of up to 500 dollars for doing their job (telling people to quit) and giving the researchers data on how many patients they advised to quit.  The point of the study is to see if money changes behavior as many doctors do not use the 5As and they have been around since 1998.  (if they think money changes behavior, why not just pay the smokers )

So, if obesity treatment and prevention is really to be tailored after all the successful tobacco strategies, we will soon be paying physicians to tell us we are fat.

(to be fair, not all doctors need money to do their job and are quite good at assessing and treating tobacco dependence - it is just a shame when they all aren't)