Is It Considered Unethical For Doctors To Profit From Pharmaceutical Companies?

Is it considered unethical for doctors to profit from pharmaceutical companies? originally appeared on Quora: the place to gain and share knowledge, empowering people to learn from others and better understand the world.

Answer by David Chan, MD from UCLA, Stanford Oncology Fellowship, on Quora:

Many doctors work directly for biotech and pharmaceutical companies as well as medical device companies full time. They are doing research, product development or management. In fact, some of them are owners of the companies. That’s fine. They are not in the practice of medicine.

For other doctors, they are sometimes consultants who are paid for their time in advising a company about drug or device development. I think that is fine too as long as the reimbursement is standard rates per hour of work. It’s unethical for doctors who are paid as consultants to not reveal that relationship prior to presenting data at scientific meetings or education symposia.

Doctors definitely should not be getting kickbacks or fees for using a medical device or for prescribing a drug.

Doctors should also not be making money by withholding treating. There are small areas of the US in an HMO system where cancer drugs are completely capitated. That means the contracted oncology group is payed a global fee for care that is all inclusive including the cost for any cancer drug used. These drugs are incredibly expensive. Any given treatment is a direct cost to the cancer specialist and withholding a treatment is a direct financial benefit. Most people find that kind of arrangement disturbing.

Probably the most ethical financial arrangement is salarying physicians. A large number of medical specialists are now affiliated with healthcare delivery systems and are salaried. This takes the financial incentive to treat or not treat out of the equation.

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