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Open Letter to Industry: Pharmaceutical Companies, Ancillary Care Providers, Medical Equipment, and Supply Companies

 

HealthTexas Medical Group certainly appreciates the value of appropriate and productive interactions with members of the healthcare industry, and indeed we hope that we can continue to work with industry to facilitate our Core Purpose of Improving the Health of the Communities We Serve.  However, it is generally recognized that some interactions between healthcare providers and industry have become too intermingled and are now contaminated by gifts, financial gains, and marketing tactics that can blur the boundaries between proprietary interest and public good.

 

In recent years we have witnessed an erosion of the public trust in the profession of medicine.  Part of this is related to the market forces that have increasingly converted medicine from a profession to a business, but a significant factor has also been the perception that physicians nationally may be accepting gifts and gratuities from industry at the very time that the cost of healthcare is skyrocketing.  HealthTexas leadership believes it is essential that as medical professionals we reclaim the moral high ground and avoid the appearances of conflict of interest that can otherwise cloud or alter the trust of the American public.  We believe that it is important for all physicians to avoid situations where there is a conflict or an appearance of a conflict with respect to pharmaceutical and ancillary provider companies.  For this reason the leadership of HealthTexas believes that healthcare providers in general would benefit from policy to provide guidance in this area.

 

I am pleased to announce that the physicians of HealthTexas Medical Group of San Antonio have taken a lead role by developing and now implementing such a policy.  This policy, by intent and content, goes a long way in helping to ensure that the moral imperative is maintained.  The policy, effective November 1, 2006, shall govern interaction among HealthTexas Providers and Associates with the pharmaceutical, ancillary care, medical equipment, and supply industries.  This policy shall apply to all HealthTexas clinics and administrative offices.

 

While recognizing the value of industry collaborations which can help speed the availability of up-to-date information, provide pharmaceutical drug samples to needy patients, and allow the coordination of joint efforts to improve the health of the communities we serve, HealthTexas’ policy aims to ensure that HealthTexas Staff members’ interactions with industry are ethical and avoid conflicts of interest that could affect patients and the integrity of the physician group.  Balancing the public imperative with the need to maintain ethical working relationships with industry can be a challenge, and we ask for your cooperation in implementing this policy.

 

The policy prohibits HealthTexas Physicians, Mid-level providers, and other HealthTexas Associates from accepting industry gifts of any size.  Physicians are already prohibited from accepting “substantial” gifts - i.e. those valued at more than $100 - under guidelines developed by physician groups such as the American Medical Association and the Accreditation Council for Continuing Medical Education.  Small gifts however, such as logo pens, pads, and tote bags are still common accoutrements elsewhere in doctors’ offices.  With the exception of pharmaceutical drug samples for use by patients, the HealthTexas Associates are prohibited from accepting gifts from pharmaceutical, ancillary care, equipment, and supply companies, however small.

 

In addition, the policy states that companies cannot pay for meals for HealthTexas Providers or Associates on or off HealthTexas facilities except under the strict guidelines of the policy and with the approval of HealthTexas Medical Group.  Any educational gifts received from industry must be used in ways that are compliant with the Accrediting Council on Continuing Medical Education’s Standards for Commercial Support.  Under those standards, any industry funding for meals would have to be used in the context of an educational activity.  Moreover, companies would be barred from any role in setting the agenda for the educational activity and would be prohibited from sending sales and marketing representatives or handing out materials, such as medical literature or logo pens or pads.  This combination of the lack of access by sales and marketing representatives and restrictions on use of industry gifts will, we believe, significantly reduce the intermingling of education and marketing that led to the need for this policy.

 

In the context of our new policy, we look forward to a continuing relationship with members of industry that shall serve the needs of the public, enhance the quality of healthcare, and improve the health of the communities we serve.

 

Thank you for your attention to this important new policy.

 

Richard S. Reyna, M.D.
President & CEO
HealthTexas Medical Group of San Antonio