The relationship between your doctor and pharmaceutical companies will be even more transparent as information is becoming available online.

Ahead of a federal law that will require pharmaceutical and medical device companies to fully disclose how much money they pay physicians, a nonprofit news organization has provided patients a tool to see exactly what doctors receive and for what reason.

ProPublica compiled data from 15 companies that have disclosed payments made to doctors from 2009 to 2012 for research, travel, speaking engagements, consulting, meals and other purposes.

Beginning in the fall, all pharmaceutical and medical device companies will be required to disclose payments more than $10 paid to physicians, to comply with a provision of the new health care law known as the Physician Payment Sunshine Act.

The 15 companies in ProPublica's database represent about 43 percent of the market share and $2.5 billion in payments to doctors. In Texas, these companies have paid more than $205 million to doctors.

Locally, numerous doctors collectively received more than $1.8 million in payments from 2009 to 2012. Most of that figure — just under $1.1 million — was for research.

The leading pharmaceuticals companies making payments to doctors in Tyler, according to the database, were Eli Lilly & Co., Pfizer, AstraZeneca, and GlaxoSmithKline.

However, in their analysis, ProPublica found that pharmaceutical and medical device companies' payments have declined in the past few years amid scrutiny.

For example, Eli Lilly's payments to doctors dropped 55 percent from $47.9 million in 2011 to $21.6 million in 2012.

Health care professionals said the rules and regulations that determine how pharmaceutical companies can sell to doctors are much stricter than in years' past.

Dr. Gary Gross, a Tyler oncologist, said some doctors won't see drug representatives for fear of being accused of a "deviant relationship."

He said there aren't many representatives with certain drugs showing up at their offices anymore. The number of drug samples and freebies such as note pads, pens and other gifts has also declined.

However, Gross views the inquiry over the relationship between doctor and Big Pharma as "overkill." Gross, who works with companies and receives payments for research, said he's happy to talk with people about his interactions.

He contends that payments to physicians, particularly for research, aren't a need for concern. He said in oncology, there is a lot of information sharing from pharmaceutical companies, which are always developing new cancer drugs.

"It's not just fluff," he said. "They do provide an asset that helps us take better care of the patients. They also have programs that do help many patients get very expensive drugs that they otherwise could not afford. So, that's another positive."

Gross said the relationship with these companies is very superficial, with frequent lunch for staff and opportunities for speaking engagements.

He believes patients are more concerned about the cost of drugs than a possibility of doctors being influenced by pharmaceutical companies.

"I'm not going to sell my soul for a pizza," he said. "So I don't think they're influencing our decision-making at all."

Dr. Stephen L. Brotherton, president of the Texas Medical Association, said this concern has been addressed with the American Medical Association's code of medical ethics and before the federal law required disclosure.

"Transparency on these sorts of things has always been recommended by physicians," he said Friday by phone. "Doctors are, first of all, instructed to be clear with their patients that they're being compensated by pharmaceutical companies."

Brotherton, who has an investment in a surgery center, said it's important to be upfront and not wait for the patient to ask about compensation from a pharmaceutical or medical device company or investments. He said he believes most payments from such companies are fair and appropriate.

"As long as it's something that doesn't cause you to pick a product for that reason only and it's a fair market value for your time, then there's nothing wrong with it and patients won't see anything with it," he said.

Brotherton understands, though, how a patient may raise an eyebrow.

"I think there probably is a line that could be crossed and that's why we have ethics instructions," he said.

An example of a suspect situation, he said, is a doctor being compensated for providing a service in a field outside of his expertise.

Ultimately, Brotherton doesn't believe doctors will be bothered by the heightened transparency.

"If patients have questions about things like that, they should ask their doctor," he said. "Most of the time, it's going to be an easy explanation for the doctor and they won't mind."



For more information about the ProPublica project, Dollars for Doctors, visit


To learn more about the Physician Payment Sunshine Act, go to







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