It wasn’t hard to work out where to cast my vote for the health story of the year.
The stand-out nominee is the Dollars for Docs database, established by the not-for-profit investigative newsroom in the US, ProPublica. Although it is leading to a veritable goldmine of stories, it’s had surprisingly little attention from the mainstream media in Australia.
Just to give you some of the background first: as part of US healthcare reform, pharmaceutical, medical and device manufacturers will be required from 2013 to provide public online reporting of gifts, payments, royalties and other benefits given to doctors and teaching hospitals.
In the meantime, however, seven companies have begun posting names and payment details on the Web, some as the result of legal settlements.
It is these disclosures, of payments totalling almost $US300 million to more than 17,000 doctors, that ProPublica has compiled into the Dollars for Docs database. The database is freely available, and ProPublica has been actively encouraging other media outlets to use it for their own local investigations.
The stories are summarised here. Below is just a selection:
• Academics at some of the most prestigious US medical schools are violating their institutions’ conflict of interest policies.
• Drug companies keep tight control on doctors’ presentations.
• In an effort to attract doctors to their events, Novartis, spent $3.6 million between 2006 and 2009 paying 150 top athletes and coaches to make appearances, give speeches, answer questions about their careers, and pose for photos with attendees.
• Hundreds of the doctors on company payrolls had been accused of professional misconduct, were disciplined by state boards or lacked credentials as researchers or specialists.
US health journalism watchdog Gary Schwitzer, the publisher of Health News Review, has called “an historic piece of journalism”
A review published by the Association of Health Care Journalists said: “ProPublica’s massive investigation into the hefty fees pharmaceutical companies have paid doctors with dubious track records stamps an exclamation point on what has been a banner year for high-profile assaults on pharma-paid physician/marketers.”
And the investigative health reporter William Heisel has commented:
Even if ProPublica had not written a single story, the nonprofit would have provided an invaluable public service by creating a database of payments from pharmaceutical companies to physicians. As the reporting has taken care to show, the payments don’t mean doctors are being controlled by Big Pharma. But the lack of transparency about those payments has kept patients in the dark while, in some cases, physicians pushed pills or treatments in which they had a financial stake. The reporters also did the drug companies a favor by pointing out how some of their top paid speakers had nasty skeletons in their closets…..These stories and the database have contributed greatly to the nationwide discussion on the influence of money in medicine and clearly have led to changes in the way drug companies vet their hired hands and how some states report physician payments.
But it is not only the content of the stories or their impact that is significant.
This project also gets my nomination for the health investigation of the year because of the way it was done, and what this says about the evolving nature of journalism.
That is, it is:
• data-driven
(Scoff not, those who might be cynical about the numeracy of journalists; some believe that data driven journalism is the future.)
• collaborative
(This story explains more.)
• involving and empowering the readership
(Readers are encouraged to use the database to search for details on their own doctors)
• explanatory
(It explains some of the complexities and shades of grey around industry funding and conflicts of interest).
If this is the journalistic goldmine that results from the payments made by only seven companies, just imagine the mega-mine that will arrive with mandatory reporting in 2013.
Perhaps the thought of this will be enough to reduce both the industry’s willingness to make such payments and the profession’s readiness to take them. Perhaps the impact will also be felt in Australia….
