An unfortunate confluence of stories has surfaced over the past few weeks. The release of data regarding compensation by pharma to physicians, required by the Sunshine Act, occurred about a week ago. The database is available for searching here.  While it splits the dollars given by pharma for research versus other, it includes a large number of entries. It is also eminently searchable. I, as I am sure did many others, quickly searched for my own information and was happy at what I did not find. While many argue over the accuracy and completeness of the data included, it is what is available.

Less than a week later came the 60 Minutes story regarding the cost of cancer therapies. The story as aired can be seen here. The story, again as aired, suggested that physicians are complicit in the problem because we make more money that way. Interestingly enough, that webpage also includes an interview with Dr. Schilsky, filmed at the Annual Meeting, talking about ASCO’s highlighting of the issue. That was not aired as part of the story. Unless you look for it online, you would never know about it.

These, together, are very likely to add to the calls to remove all physician/pharma interactions that can be seen as influential. After all, are they not prodding us on to prescribe these more expensive drugs? Several states have barred any “gifts” from pharma, from pens on up. Although some will still cite the old examples, the days of pharma sponsored “educational meetings” with a one- to two-hour seminar followed by an all-day ski session or the like are long gone. What is also gone, unfortunately, is the providing of educational materials such as textbooks, etc. As a resident/fellow with significant educational loans and living expenses, getting a copy of the Principles and Practice of Oncology was greatly appreciated, and I cannot say I looked at the sticker on the inside of the front cover more than once (if that).

Somewhere, there should be a reasonable (probably never happy) medium, and therein lies my “modest proposal.” What if pharma companies were to form and fund a consortium? Monies in that consortium could be used to fund online access to major journals and texts for physicians wishing access. Individual companies would not be highlighted or even named unless specifically searched for. The consortium could potentially be funded as a 501(c)(3) with an educational mission. Specific companies would also not be seen as directly giving “things” to specific physicians. This could certainly help the companies. Physicians getting access to journals and the most recent editions of texts would help in patient care by increasing the opportunity to get access to the most recent information.

I know this may come off as very naïve and “blue sky” in its thinking. I also know there are issues and concerns that others can quickly come up with. It is, however, a first stab at an idea. We are at a time when there is going to be more pressure to change the status quo. I would prefer the change come from within as opposed to without.