Just back from a trip to the UK where, as you may have heard, the pollies of all parties are being crucified over their expense claims.
Some have been rightly castigated for claiming big ticket items such as moats, or claiming huge sums for renovating their houses at taxpayers' expense, only to sell them at huge profits.
But many of the claims were for apparently trivial items such as ginger biscuits - or entertainment deemed 'too lavish' by public opinion, if not the auditors.
Sounds remarkably similar to our own code of practice on pharmaceutical hospitality.
On my last day in London I caught up with an old schoolmate who is now a backbench Labour MP. I had the surreal experience of sitting with him by the duck pond in Kensington Gardens on a blustery Saturday morning as he worked his way through the Daily Telegraph's comprehensive 'expenses file' that lists every MP's claims.
"He's gone ... she's finished ... " he muttered, as he read the details of colleagues who had put in what the newspaper claimed were 'ludicrous' claims for things like $6 dog bowls and $25 minibar bills. He predicted that his own career was also over, despite a relatively clean bill of health.
"I'll be happy to take early retirement with honour. I want to be able to walk around my hometown and still be able to look people in the eye," he told me.
This was all due to the publication of the itemised accounts of exactly who received what - information the politicians were unwilling to reveal but which was exposed by the media. As we have seen with our own politicians, such as the recently resigned Labor defence minister Joel Fitzgibbon, there is now gathering momentum for complete transparency and accountability in relation to elected representatives.
But the implications go beyond the political arena, and the medical profession should take heed. If a similar list were released for all doctors showing every dollar spent on your meals, entertainment, gifts, sponsorship and other financial support from industry, how would it look to your patients?
In the UK, many of the MPs have tried to argue that their claims were justified but have been taken out of context. Joe Public doesn't see it that way, especially as the politicians' finances have been kept secret until now.
Perhaps the lesson for doctors is to be pro-active and emulate Dr Martin Tattershall's example of disclosing all interests that might influence prescribing and treatment.
Posted by Peter R Mansfield on Tuesday, 23 June 2009
Congratulations on this post Dr Woodhead. In the USA several states are enacting "Physician Sunshine Acts" laws which will lead to full public disclosures of pharma-physician payments/meals/gifts. I gather the term "sunshine act" applies to laws meant to shed light into dark places.
But it is not just gifts and consulting payments - several court cases have shed light on other practices that more directly bias the scientific literature including ghost-writing - see http://www.thestar.com/living/article/654423
Personally I viewed some of the documents released from these court cases and pertinent to my specialty of psychiatry and have a commentary on them here with links to original documents that are publically available - http://www.healthyskepticism.org/documents/Antipsychotics.php Posted by Dr Peter Parry on Tuesday, 23 June 2009
