National report - As the relationship between dermatologistsand drug and device manufacturers tightens, some experts say itsometimes can be difficult to discern the point where cooperationapproaches collusion. Others say any financial tie crosses theline.
A free lunch - literally
Over the last 20 years, industry has changed the way it deals with physicians, says June K. Robinson, M.D., professor of clinical dermatology, Northwestern University and author of a recent American Academy of Dermatology (AAD) presentation on the subject of industry relationships.
Kenneth Beer, M.D., assistant clinical instructor of dermatology, University of Miami and director of Palm Beach Aesthetic Center in West Palm Beach, Fla., where his practice is more than half cosmetic, elaborates.
"Dermatologists have always had a very strong relationship with industry." For example, he says, "The industry does not have manpower, education or licensing to do training. So who else is going to train doctors" to use new products?
As with any relationship, though, Dr. Beer says, "There's potential for abuse."
Walking the line
"If any relationship in medicine puts one's own interest - or anyone else's - above those of the patient, it's much too cozy," adds A. Bernard Ackerman, M.D., director emeritus, Ackerman Academy of Dermatopathology, New York.
He says that nowadays, such relationships are as common as they are unethical. And dermatology is one of the worst offenders. "Who, seriously, can justify selling products in one's office? It's patently unethical. And yet this is the order of the day," he says.
For Dr. Robinson, even the smallest gifts such as logo-bearing pens, remind physicians to prescribe a company's products. Therefore, she says, "Anything with anybody's product or company name on it represents a tie."
Dr. Fleischer counters, "As many of the irrational reactionaries argue today, any and all gifts or transfers from industry to physicians constitute a conflict. Thus the 12-cent pad of paper received from a supplier should, in theory, be fully disclosed. This is patently absurd."