Monday, March 2, 2009

More from Family Physicians President on Sunshine

A little while back I posted a comment critical of Dr. Ted Epperly's position as President of the American Academy of Family Physicians:

Dr. Epperly has sent me a statement and asked that I share it, which I am pleased to do immediately below. After his statement I shall add a couple of my own comments.

Says Dr. Epperly:

Communication is key to high quality health care, and family physicians have consistently advocated for transparency not only in the physician-patient relationship, but also in interactions between physicians and other members of the health care community.
Nowhere is this transparency more important than in the dealings between physicians and the manufacturers of pharmaceuticals, medical supplies and devices, and biologicals that form the foundation of many patients’ treatment plans.
The American Academy of Family Physicians and I personally hold the tenet of transparency to be among the most important elements of professionalism. That’s why I was somewhat surprised by the response to my recent comments about the Physician Payment Sunshine Act of 2009, a bill that requires manufacturers to disclose gifts, financial agreements and other dealings they have with physicians.
The intent of my comments was to emphasize the need for legislation that provides for reasonable reporting on physicians, allows recourse if mistakes were made in that reporting, and ensures that physicians would not have yet another law demanding unnecessary or redundant administrative paperwork. The AAFP continues to study the bill and will be following its progress through the legislative process.
The AAFP is not disparaging the Sunshine Act and we are not taking the industry side on this. We are looking for transparency legislation that
● minimizes the administrative burden that reporting requirements
would place on physicians;
● enables the physician to correct incorrect reporting data before
the companies releases it for publication; and
● ensures the reporting requirements do not have a chilling effect
on efforts to educate physicians about research and new developments in diagnosis and treatment.
Such provisions will improve an already important legislative effort.

Ted Epperly, MD
American Academy of Family Physicians

OK, it's me again... I want to report to you first that since my initial post, I was privy to some correspondence between Dr. Epperly and some of my esteemed colleagues who are very critical of medicine's relationships with Pharma. I was impressed by Dr. Epperly's openness to our critical input and his apparent surprise that we had initially seen the AAFP position as being so close to industry apologetics. I think we were reassured of his good will and genuine desire to see AAFP back sound legislation. I also think we were able to educate him a little as to the dangers appearing to be too cozy with the industry side. (Until very recently, no medical organization had to worry about looking bad because it was leaning too close to the industry side. Now, thankfully, it's an issue for active discussion and debate.) So I want to give Dr. Epperly, as the president of my specialty academy, full credit on those scores.

Now, that said, I continue to dissent from the tone and tilt of these new comments. The substance is hard to debate--we don't want busy family physicians further hassled by bureaucracy; we don't want to impede real education; and we don't want lies about people posted on the web. But none of these issues really seem to be serious concerns of the proposed Federal sunshine legislation, and these feared repercussions have not happened in those states that have already enacted sunshine provisions. The fact that the AAFP is very worried about these things happening still seems to suggest a pro-industry tilt that its members ought to be concerned about. It still appears that AAFP is listening very carefully to the critics of the sunshine legislation, and relatively less to its advocates, even those advocates within AAFP ranks. I look forward in the future to support by AAFP for this legislation, not lukewarm willingness to study it and carping about improbable consequences.

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