ProPublica published a pair of articles last night in their ongoing investigation into pharmaceutical company payments to doctors who give promotional talks on the firms' behalf.

One of the articles called out certain members of Stanford's medical school faculty, including the vice chairman of Stanford’s department of medicine, as breaking the Stanford Industry Interactions Policy by giving such talks.

Philip A. Pizzo, dean of Stanford's School of Medicine, got wind of the ProPublica article last week, and he was not pleased. This is evidenced by the following item in The Dean's Newsletter, in which Pizzo implies that excuses he's heard from some busted docs stretch the bounds of credulity in the same way that a teenager's not really being clear on that Don't-Stay-Out-Till-Six-A.M. policy does.

Although it seems implausible, I suppose it is possible that a Stanford faculty member might still be unaware of the School of Medicine Policies on Academic Industry Relationships. These policies are listed on our available website (see: http://med.stanford.edu/coi/siip/), have been widely disseminated, and I have communicated about them frequently as changes have taken place over years. Here's just a sampling of some of those communications over years:

(A list of 17 items follows.)

Why am I focusing on this issue and some of my past communications about academic industry relations now? In 2010, the Congress passed legislation that requires pharmaceutical companies to disclose all payments to doctors by 2013. Seven pharmaceutical firms are now doing so, and the databases for these companies are publicly available. ProPublica, an independent, non-profit online investigative newsroom that produces journalism in the public interest, has been utilizing these databases and is running a series entitled, Dollars for Docs, What Drug Companies are Paying Your Doctor (http://www.propublica.org/topic/dollars-for-doctors).

We have been informed that very shortly, ProPublica will be releasing a new investigation about how pharmaceutical firms have paid academic researchers and clinicians to participate in speakers' bureaus that market their products. Unfortunately, a small number of our faculty will be highlighted in this article.

Our preliminary investigation suggests that some of the individuals likely to be reported by ProPublica had understandable reasons for confusion about Stanford's policies and have already addressed them and ceased activities like "speakers' bureau" participation. Others, though, offered explanations why their activities continued that are difficult if not impossible to reconcile with our policy, and here we have concerns (emphasis mine). I am fully cognizant that changes of the type we have witnessed in academic-industry relations and related conflicts of interest take time to disseminate and also to result in changes in behavior and activity. But, as noted above, there have been a lot of prior communications about the policies at Stanford and many stories in the lay and medical press about the problems associated with physicians serving in marketing roles. This is unacceptable, certainly for anyone with a Stanford title.

If you're interested in finding whether your own doctor is on the pharmaceutical payroll, ProPublica has put together a database of such providers, searchable and browsable by state.

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The California entries are listed here, alphabetically by doctor, though you can also arrange the list by city. Plenty of Bay Area docs are on the list, paid varying amounts by the seven pharmaceutical companies included in the database. Whether those payments influence prescription decisions... easy to imagine, tough to prove. And unpleasant to ponder.

Philip PizzoPhilip Pizzo

Stanford Docs Slapped on Pharma Talks; ProPublica's Database of Doctor Payments