Investigative innovator ProPublica launched a new project this week, a national database of doctors and the money they have received from pharmaceutical companies. It teamed up with the Boston Globe, Consumer Reports, NPR, the Chicago Tribune, and PBS as investigative partners. To compile the Dollars for Docs database, web developer Dan Nyugen and reporters Charles Ornstein and Tracy Weber collected the information from seven major pharmaceutical companies who have posted their payroll information online, and cross-referenced the doctors’ names with other publicly available disciplinary records. The database is searchable by state or by doctor’s name, and there’s also a list of the 384 top-earning health providers who made at least $100,000 from pharmaceutical companies (in 2009 and early 2010).
The implied story, of course, is that checks from pharmaceutical companies—usually for speaking fees at pharma-sponsored conferences, but sometimes for travel and meals as well—would inappropriately influence doctors to prescribe those companies’ drugs at a higher rate than they normally would. Indeed, there have been some hefty lawsuits through the years involving some cases where a quid-pro-quo link could be clearly drawn.
But in general, that remains a tricky thing to investigate, as individual drug prescriptions are not public information. ProPublica is quick to point out throughout the Dollars for Docs web pages that it’s perfectly legal for doctors to receive payments from pharmaceutical companies, “but it does raise ethical issues.”
What ProPublica can show, however, is that the highest earning doctors on Big Pharma’s payroll are not necessarily the most reputable in the medical field:
Drug companies say they hire the most-respected doctors in their fields for the critical task of teaching about the benefits and risks of their drugs.
But an investigation by ProPublica uncovered hundreds of doctors on company payrolls who had been accused of professional misconduct, were disciplined by state boards or lacked credentials as researchers or specialists.
(The details of some of those disciplinary cases will make you cringe.)
This project is a huge undertaking, which some have criticized for being too big, and others for being too limited (see the debate going on over at Knight Science Journalism Tracker). Regardless of the conclusions ProPublica and its partners have been able to tease out of the data thus far, the database alone is an important resource; it’s a great opportunity for reporters and editors to localize an aspect of health care reform that’s often merely abstract. For example, Judy Graham from the Chicago Tribune (one of the media partners) wrote a piece listing the twenty-five highest earning doctors in Illinois, where they work, what kinds of drugs they get paid to present on, and what they had to say when Graham asked them about it.
In a conference call on Thursday, ProPublica reporters Ornstein and Weber spoke to reporters and editors from dozens of news organizations about how to best use the database to find stories their readers would care about. Weber stressed several important caveats. First, with such a large database, there are bound to be doctors who share the same name, so it’s important to double-check before publishing anything about a particular person. For instance, Weber said that while researching disciplinary records, they found seven doctors with the same name in Manhattan alone.
Second, the database is in its beginning stages, so one can’t take the doctor payments at face value: some drug companies reported on the last eighteen months of payments, others only reported on the last six months, and only seven drug companies have thus far disclosed anything at all. So just because a doctor isn’t listed in the database, doesn’t mean that he or she hasn’t received payments from drug companies, and those doctors who are listed may have received way more than the amount listed. (By 2013, as a result of the health care bill recently passed by Congress, all U.S. pharmaceutical companies will have to disclose this information, and ProPublica will continue updating the database to reflect that information.)