Dollars For Doctors - How Industry Money Reaches Physicians

Few days went by last year when New Hampshire nephrologist Ana Stankovic didn't receive a payment from a drug company. All told, 29 different pharmaceutical companies paid her $594,363 in 2014, mostly for promotional speaking and consulting, but also for travel expenses and meals, according to data released Tuesday detailing payments by drug and device companies to U.S. doctors and teaching hospitals.

Stankovic's earnings were certainly high, ranking her about 250th among 606,000 doctors who received payments nationwide last year. What was more remarkable, though, was that she received payments on 242 different days — nearly every workday of last year.
Reached by telephone Tuesday, Stankovic declined to comment. On her LinkedIn page, Stankovic lists herself as vice chief of staff at Parkland Medical Center HCA Inc. in Derry, New Hampshire, and as medical director of peritoneal dialysis at DaVita Inc., also in Derry.

That doctors receive big money from the pharmaceutical industry is no surprise. The new data released by the Centers for Medicare and Medicaid Services shows that such interactions are widespread, with not only doctors, but thousands of dentists, optometrists, podiatrists and chiropractors receiving at least one industry payment from August 2013 to December 2014.
What is being seen for the first time now is how ingrained pharmaceutical companies and their sales reps are in the lives of those who write prescriptions for their products. A ProPublica analysis found that 768 doctors received payments on more than half of the days in 2014. More than 14,600 doctors received payments on at least 100 days in 2014.

 "There are physician practices which have very deep relationships with pharmaceutical representatives, where they are a very integral part of the practice," said Dr. Aaron Kesselheim, an associate professor of medicine at Harvard Medical School who has written about industry relationships with doctors. Kesselheim said that to have such extensive contact with industry reps can indicate that doctors are getting their information about the drugs they prescribe from the companies that make them, and not from impartial sources. "There's good evidence that that affects prescribing practices and physician behavior."

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