Tuesday, February 23, 2010

Internal Medicine Residencies and Pharma Money: We Don't Like It but We Take It

Duff Wilson in the New York Times:
http://www.nytimes.com/2010/02/23/business/23docs.html

--offered a handy synopsis of a paper by Dr. Laura L. Loertscher and colleagues (subscription required to access). The Association of Program Directors in Internal Medicine (residency program directors) conducted a survey of their members. A little more than half, 55.9% reported receiving some form of money from the pharmaceutical industry; the most common item funded was food for lunch conferences (90%). A wide majority (72.0%) of the directors disapproved of taking these funds, but were swayed especially by the popularity of these benes among the residents (40%), as well as by a general sense of the lack of alternative funding sources. The authors remarked that overall this represents an improvement over a 1990 survey that showed 88.6% of residencies taking money.

The surveyers next tried to correlate one measure of a residency's quality, the percentage of residents who pass the Board exam, with taking Pharma money, and found a direct inverse correlation--the worse the residency, the more likely it was to accept Pharma money. (One has to wonder whether if this word gets around, "drug lunches" will still be such a popular item among the residents.)

Wilson's article in the Times noted that the Accreditation Council for Graduate Medical Education has the authority to end this practice instantly by fiat. The authors, like good internists, did not make such a suggestion, but rather called for more research.

Loertscher LL, Halvorsen AJ, Beasley BW, et al. Pharmaceutical industry support and residency education: a survey of internal medicine program directors. Archives of Internal Medicine 170:356-62, Feb. 22, 2010.

5 comments:

Michael Kirsch, M.D. said...

"and found a direct inverse correlation--the worse the residency, the more likely it was to accept Pharma money.

How do you define 'worse'? What was your point about stating this presumed inverse relationship?
www.MDWhistleblower.blogspot.com

Howard Brody said...

Sorry, Dr. Kirsch, I thought that was clear in the post itself: "The surveyers next tried to correlate one measure of a residency's quality, the percentage of residents who pass the Board exam, with taking Pharma money..." One can certainly criticize the study by claiming that this is a very crude and impartial measure of the quality of a residency program. I am not sure what measure is both objective and generally accessible, however, that could have been used instead.

Michael Kirsch, M.D. said...

Howard, I believe that we both agree that measuring physician quality is a murky enigma. What is happening it that the Quality Police are gathering data that can be easily counted, but how much does this really count?

Anonymous said...

What a great resource!

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