Prevention Is the Key in Developing Physician-Industry Relationships

Another key source is the guidelines on compliance by the Office of Inspector General (OIG), an agency within the US Department of Health and Human Services (http://oig.hhs.gov/testimony/docs/2008/demske_testimony022708.pdf ).

According to Ms. Smith, the OIG also offers a hotline that physicians can use to ask for advice.

Ms. Smith recommends that physicians use these resources to educate themselves and to raise the right questions as they work with a compliance officer or attorney in establishing ties with industry.

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Table 1. AMA Guidelines: Gifts to Physicians from Industry

Perception is Reality

For Gavin Setzen, MD, Chair-Elect of the Board of Governors (BOG) and Immediate Past-Chair of the Socioeconomic and Grassroots Committee of the AAO-HNS, as well as an otolaryngologist in private practice at Albany ENT and Allergy Services in Albany, NY, transparency is critical to, above all else, protecting the trust between physician and patient.

One has to be very careful about how these relationships [between physicians and industry] evolve, he said. I think from the patient’s perspective, there is a potential problem even if there is only the perception of an improper relationship.

To dispel any sense of impropriety, Dr. Setzen does not allow any products with logos of pharmaceutical or medical device companies in his private practice.

He also thinks that organized medicine-representing bodies, such as the AAO-HNS, must be free of any bias or inappropriate relationship in how it advertises itself and how it counsels its members.

Scrutiny and oversight are only going to become more intense, and to maintain professionalism and credibility as an organization or individual physician, I think one has to become more aware of these issues and develop a compliance program to ensure that physicians remain informed about and adhere to recommendations such as those proposed by the AMA, he said.

From a legal point of view, the importance of perception is also critical. According to Ms. Smith, there is a view in the enforcement community that any joint venture between a physician and medical device company, for example, in itself violates the antikickback law. The concern is that a physician’s financial stake in the profit of the device may influence his or her use of the device. Although this view can be rebutted, said Ms. Smith, it does indicate just how vulnerable physicians can be in these relationships.

To reduce the risk involved in forming these relationships, and any perception of impropriety, she emphasizes prevention as the key and encourages physicians to understand enough about the issues raised by these relationships to ask the right questions and seek help in the right places.