Do Doctors Always Tell the Truth?

No, reports the Milwaukee Journal Sentinel

Kudos to the Journal Sentinel and reporter John Fauber for digging up the difference between fact and fiction when it comes to medical researchers at the University of Wisconsin medical school. At least nine doctors there told the medical journals which published their research findings that they had no conflicts of interest with companies that figured into their work. After digging into university records, the Journal Sentinel uncovered a different story.

Meet Minesh Mehta, one of the university’s cancer specialists. Mehta co-authored an article about TomoTherapy, a radiation therapy system developed by researchers at the university. In March, the Journal of Radiation Oncology Biology Physics published his research, which assessed 3,800 treatments using the therapy. In July 2008, the Journal of Radiation received Mehta’s paper. It received a revised version in November which was accepted for publication a week later. In the published article, Mehta did not reveal his financial ties to the manufacturer of the radiation technology although the other authors did.

The newspaper discovered that less than two months before Mehta sent his research findings to the Journal of Radiation, he told the university that he had just started working as a consultant to TomoTherapy, Inc., a Wisconsin-based firm that makes the systems, and he was reducing his work load at the university. He disclosed that his compensation would exceed $20,000, along with stock options then valued at less than $10,000. The Journal Sentinel reported that, in 2008, Mehta received consulting income from the company totaling $75,000 for twenty days of work. His stock options climbed in value to between $10,000 and $20,000.

The paper found other similar examples, and noted that “a lack of disclosure in several high profile national cases has undermined the integrity of the medical field.” Disclosure, it said:

alerts doctors and others who read medical journals to potential bias and allows them to weigh the credibility and value of the articles.

In other words, disclosure tells practicing doctors whether some new intervention is worth trying on their patients. And it can help patients learn if their doctors are doing what helps them, as opposed to helping technology makers get rich.

The press needs to be the watchdog for these sorts of conflicts of interests and let the public know about them. The Journal Sentinel did the kind of connect-the-dot reporting that’s so rare these days. The story explored the complicity of the medical journals themselves, and pointed out that disclosures come in different stripes—those that narrowly define what is a conflict and those that are vague and incomplete. As an example, it cited the fuzzy disclosure practices of various orthopedic surgery journals:

Often they don’t say what the financial relationship is or spell out how much money has been paid. Sometimes the disclosures don’t even say which company is paying the author.

The Journal Sentinel story is significant. It shows that despite all the hand-wringing rhetoric from the journal editors, the professional associations, and others about fuller and better disclosure, the doctors still like to bend the rules. It also shows that good reporting from regional newspapers is not yet dead. These kinds of stories used to be bread-and-butter fare at regional papers known for good reporting in Milwaukee, Detroit, Des Moines, and Cleveland. We hope the Journal Sentinel continues to dig, and that others will do the same. Keeping an eye on the academic medical centers in your own backyard and the docs who work there can make for some great local reporting.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.