Viewpoint

In the Interest of Full Disclosure

FROM THE CHIEF MEDICAL EDITOR

Larry E. Patterson, M.D.

How many times have you been to a lecture where it is a bit too obvious that the speaker is being paid to say something favorable about a manufacturer's product? You hear a speaker at one symposium describe the wonderful attributes of antibiotic A only to hear the same speaker's comments in another forum about the superiority of antibiotic B? Or a doctor who feels that laser Y is by far the best platform until next years release when laser Z is the best, especially because they are being paid to say so?

There has been a groundswell of frustration building based on the lack of full financial disclosure in our profession. To that point, I recently received an e-mail from a colleague who expressed his own feelings on the subject. He clearly feels that bias has seeped into many of the lectures that he hears and articles that he reads. It is his opinion that financial arrangements with manufacturers are bound to affect the conclusions that are drawn by those being paid and that industry has far too much control over the information that is disseminated to the ophthalmic community. While most of us would like to believe that we would not be influenced by financial persuasion, if we don't openly admit to our relationships with industry, our peers (like my e-mailing friend) may think we have something to hide.

So, in this climate what can we as doctors, and for many of us, also as members of editorial boards, do? Legislation is pending on the federal level that would require large companies to disclose payments, gifts, travel expenses and such along with the names of the physician recipients. This information would be posted on a Web site for all to see.

While peer-reviewed journals have had financial disclosure policies in place for some time, trade journals such as Ophthalmology Management have only recently begun to explore such options. Here at OM, we have begun to put in place our own policy on financial disclosure. We think readers deserve to decide for themselves if an author is biased.

Clearing the Air of Suspicion

There are good points to be made on both sides of the disclosure debate. I myself have been paid, usually a paltry sum, but payment nevertheless, to speak on behalf of a company whose product I already use. And, while I feel this delivery of information can be done ethically, until some form of resolution is reached, I think it's in everyone's best interest to fully disclose all financial relationships with manufacturers. We may not always be able to provide full disclosure, but we will make every attempt to do so.

Finally, it's also important to note that funding is not necessarily a bad thing. Pharmaceutical and device manufacturers have a long tradition of bankrolling research that has changed the way we practice, and more importantly, that has improved the lives our patients. And that's the true value in our relationships with industry.