The Reply

      Thank you for your thoughtful letter responding to my recent editorial. You are absolutely right that “the devil is in the details” with respect to the suggested Web site for listing the names of physicians, companies involved, and amount of money received. The entire process would, of course, have to be negotiated before it could start. Let me give you a “rough draft” of one possible way to create and pay for such a Web site.
      The cost of the Web site would be shared by the Food and Drug Administration and industry. I do not think that this would be a very expensive operation. Perhaps, salaries for 2 or 3 full-time employees would represent most of the cost of the operation, which would be housed at the Food and Drug Administration in Washington, DC. The only information listed for the physicians would be their full name and the city or town where their office was located. No personal information such as Social Security numbers, phone numbers, and so forth would be listed. Same or similar name confusion could be avoided by listing the street where the physician’s office was located.
      This Web site would be a potential source of information for all interested parties. I suspect that use would be modest, but only time and testing will tell. The information available on the Web site is modest and would be available to the public without charge. I suspect that patients would rarely be interested in this information. I also suspect that private practitioners would not use this information nor would their patients. I believe that academicians and journals would use this information when inviting individuals to write editorials about a specific product. Perhaps medical schools would look at this information in making faculty appointments and promotion/tenure decisions. Finally, grant review committees might be interested in this information. With respect to your mentor, you might access the information or not depending on whether you wanted to know. How you used that information would be entirely up to you. With respect to confidential personal information, none would be asked from physicians. In fact, physicians would not be involved in the process at all. Instead, industry would send the Web site administrators the information electronically, and the administrators would merely post the information. You would not have to be involved at all.
      The scenario that I have just painted is hypothetical. The negotiations with industry, professional societies, and the federal government would work out the devilish details. I am sure that they will not ask me!! Thanks for writing to me and The American Journal of Medicine.

      Linked Article

      • To the Editor
        The American Journal of MedicineVol. 118Issue 10
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          I read with serious interest your editorial1 in The American Journal of Medicine, February 2005 (issue), entitled “Doctors in the Drug Industry: How Can We Handle Potential Conflicts of Interest?” As you pointed out, the potential for conflict of interest has existed in the profession of medicine long before the 21st century. I am a proponent of disclosure, but I am skeptical of databases. I personally would have no problem telling my patients (as I have in the past) that I have provided education conferences for drug company A, drug company B, or drug company C.
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