{"id":35185,"date":"2013-03-10T08:41:16","date_gmt":"2013-03-10T12:41:16","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=fellowship-training&p=35185"},"modified":"2013-03-10T16:39:29","modified_gmt":"2013-03-10T20:39:29","slug":"you-are-my-sunshine-blogging-from-acc-13","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2013\/03\/10\/you-are-my-sunshine-blogging-from-acc-13\/","title":{"rendered":"You Are My Sunshine: Blogging from ACC.13"},"content":{"rendered":"

Several Cardiology Fellows who are attending ACC.13 in San Francisco this week are blogging for CardioExchange. The Fellows include\u00a0Tariq Ahmad<\/strong><\/a>,\u00a0<\/em>Megan Coylewright<\/strong><\/a>,\u00a0<\/em>Jeremiah Depta<\/a>,\u00a0Kumar Dharmarajan<\/a>,\u00a0<\/strong><\/em><\/strong>\u00a0Payal Kohli<\/a><\/strong><\/em>,\u00a0and \u00a0Sandeep Mangalmurti<\/a><\/strong><\/em>.\u00a0View the previous post\u00a0here<\/a>\u00a0and the next one here<\/a>.<\/em><\/p>\n

<\/em>Despite baggage and flight delays, I was fortunate enough to arrive to\u00a0ACC in time to see a series of provocative presentations on the topic of\u00a0conflict of interest in medicine. The symposium entitled “Regulatory\u00a0Oversight and Protection of Patients’ Interests” <\/a>discussed the problems\u00a0of conflict at both the micro (physician) and macro (governmental)\u00a0level, and raised issues that all cardiologists have to eventually face.<\/p>\n

One of the most compelling presentations was by Dr. Steve Nissen of the\u00a0Cleveland Clinic, who needs no further introduction. His focus was on\u00a0the potential financial conflicts that arise between individual\u00a0physicians and industry. While acknowledging and applauding the\u00a0benefits of a close working relationship between these two groups, he\u00a0also notes the obvious potential pitfalls. He argues that red flags\u00a0should go up for physicians when collaboration moves its priorities from\u00a0promoting the general welfare to promoting industry revenue. Red flags\u00a0should stay up when money changes hands in these relationships, creating\u00a0dual loyalties for the provider.<\/p>\n

The unfortunate results of these conflicts can be insidious and far\u00a0reaching. Impartial scholarship is replaced with articles ghost written\u00a0by industry, with negative results quietly buried. Legitimate CME is\u00a0replaced with education that is actually just a promotion vehicle. Most\u00a0corrosive of all, there is an increase in public skepticism of the\u00a0motives of all physicians, not just those with dual masters.<\/p>\n

Of course, the most difficult conflict of interest to recognize is our\u00a0own. As Upton Sinclair famously stated: “It is difficult to get a man\u00a0to understand something, when his salary depends upon his not\u00a0understanding it.” Perhaps the best we can hope for sometimes is\u00a0transparency. To that end, the Affordable Care Act of 2010 including a\u00a0provision known as Physician Payments Sunshine Act (PPSA) which mandates\u00a0that drug and device companies collect and reveal information on the\u00a0amount they have provided to physicians; this information will then be\u00a0made public, so that any person (patient, employer, journalist) can see\u00a0which doctors are receiving what from whom.<\/p>\n

There has been significant\u00a0delay in implementation of PPSA, but the regulations were finalized on\u00a0Feb 1, 2013. Companies will have to begin capturing this data on\u00a0August 1, 2013, and submit reports to the federal government by March,\u00a02014. Sunshine Act data is scheduled to be placed on a public website\u00a0next fall. In the meantime, interested parties can access some of this
\ninformation on\u00a0http:\/\/www.propublica.org\/series\/dollars-for-docs<\/a>.<\/p>\n

For\u00a0<\/em>more of our ACC.13 coverage of late-breaking clinical trials, interviews with the authors of the most important research, and blogs from our fellows on the most interesting presentations at the meeting, check out our\u00a0Coverage Headquarters<\/a>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

“It is difficult to get a man to understand something, when his salary depends upon his not understanding it.”<\/p>\n","protected":false},"author":457,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[1711,1099],"class_list":["post-35185","post","type-post","status-publish","format-standard","hentry","tag-acc-13","tag-health-policy"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/35185","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/457"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=35185"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/35185\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=35185"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=35185"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=35185"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}