Transparent Hospitalists


Six weeks ago hospitalist Frank Michota Jr., MD, posted on the Cleveland Clinic's Web site that he receives at least $5,000 per year in fees from pharmaceutical firms Sanofi-Aventis U.S. Inc. and Scios Inc. Since then, not one of the 100 or so patients he's encountered has asked about it.

Still, hospitalists and specialists at the teaching hospital now are required to publicly disclose their financial ties to the pharmaceutical and medical device industries. The effort is aimed at increasing physician transparency and avoiding conflicts of interest—real or perceived.

As director of academic affairs for the hospital's Department of Hospital Medicine, Dr. Michota appreciates the credibility that the disclosure provides for research. But he thinks it does little to forward patient care. Because most hospitalists are required to use drugs or devices based on formularies, whether they have financial ties to the companies making the drugs or devices is irrelevant, he says.

"It’s not the patient that's looking at this stuff," Dr. Michota says, adding, "the disclosures are more for the ethereal discussions."

He emphasizes most physicians don’t seek out relationships with drug- and device-makers.

"I use Drug A because it's on my formulary," he says. "I have a lot of experience with [Drug A] because it's on my formulary. I'm then asked by the company to research it, because I have experience with Drug A. That's how it works, not the other way around."

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