Look for the money behind the product endorsements

June 18, 2018

When listening corporate bias from the podium became too much, Michael Brown, OD, MHS,-CL, FAAO, looked up the lecturer under the Physician Payment Sunshine Act. And then he found his own name.

The views expressed here belong to the author. They do not necessarily represent the views of Optometry Times or UBM Medica.

I attended a recent continuing education (CE) meeting at which I heard a couple of lecturers whose corporate bias was coming through loud and clear.

They seemed to assert that this particular eye drop worked better than any other for treating a particular condition.

I knew perfectly well from many years of treating this particular condition without their particular drop on our hospital formulary that this statement wasn’t necessarily true.

While honorable people may differ, I thought they were shilling, plain and simple, so much so that I felt like standing, calling them out, and throwing my water bottle (which I had bought and paid for-it was not a gift) toward the stage.

But rather than make a scene and risk being escorted out by security, I decided to do something much more constructive: text rant to a friend.

“OMG According to So and So, Brand X eye drop cures all! How in the world my patients have not all gone blind without it is a mystery for the ages!”

My friend texted back, “Look them up on the CMS website. While you’re there, check out some other big names.”

Website discloses financial ties
My friend was referring to OpenPaymentsData.CMS.gov, the federal database that was created under The Physician Payments Sunshine Act (PPSA), a section of the Affordable Care Act (ACA) of 2010. The website purportedly shows how much allopathic and osteopathic physicians, dentists, chiropractors, podiatrists, and optometrists receive in payments of various types from medical product manufacturers.

Previously from Dr. Brown: Like books and e-readers, old and new can live together in harmony

I searched the website as my friend suggested, but I immediately wished I hadn’t.

My jaw dropped at the ungodly sums of cash paid out for a few kind words about a product. Had my wife been sitting there, she would have said, “Close your mouth, honey.”

To put this in context, I’m a grunt clinician in the trenches, a peon in the grand scheme of things, who doesn’t get out much.

Usually, I’m too busy trying to scope out a good spot and spread out my belongings in order to make 100 minutes of lecture somewhat tolerable to pay much attention to the corporate disclosures at the beginning of a CE course.

But now that the topic was on my radar, I wondered what that website says about me?

Similar name challenge
It is not easy being a Michael Brown. I have been surrounded by other Michael Browns my entire life: high school (the two of us always argue about which was the “good looking one” at class reunions), college, and around University of Alabama-Birmingham (UAB) during optometry school.

Now, in some kind of cruel karmic confluence, I share the same city with three other Dr. Michael Browns-a urologist, a gastroenterologist, and a pediatric dentist.

Two of them share “Wayne,” which rhymes with my middle name (Dwayne), for a middle name, while the fourth has the same middle initial as me.

Are you still with me? Good, because that means you’re several steps ahead of the federal government.

It turns out that I’m more of a corporate tool than I had believed. This is a problem for me because I work for an organization that has explicit rules about gifts and payments from “outside sources.”

According to the website, I was paid $12.35 in 2013, $246.27 in 2014, $171.53 in 2015, and nothing in 2016.

The $12.35 and nothing seemed about right, but 2014 and 2015 seemed way off.

Disputes must be timely
As I examined the individual payments from 2014 and 2015 more closely, I found that the majority of my bounty came from a pharmaceutical company I didn’t recognize.

So, I looked up their products. There wasn’t a single ocular medication or device on the list.

There were several bladder drugs.

Related: The importance of discovering your professional purpose

A note to federal watchdogs: I’m fairly smart, but there aren’t enough Holiday Inn Expresses in the world for me to sleep in to make me that smart.

Apparently, my urologist namesake likes to have corporate lunches and “education” for his staff.

Big deal. That’s pretty reasonable and par for the course, if you ask me.

I would set the record straight-if I could.

You can file an appeal but only by the end of the calendar year in which the data was published. Once the big ball drops in Times Square, your corporate take for the reported year becomes a part of the permanent record.

It turns out I did screw up once to the tune of $62.86 when I stumbled into a corporate reception at the American Academy of Optometry meeting in New Orleans in 2015.

That amount exceeds my single occurrence gift limit of $20.00 and my annual limit of $50.00.

Oops. My bad.

Pay attention to those corporate ties
I would be happy to reimburse the multibillion-dollar company that served me those lukewarm meatballs if someone could just tell me where to direct the payment.

There! Feels good to have that off my chest.

Later at the meeting, I found myself back in the same lecture hall listening to a fresh-faced, young corneal specialist giving an excellent talk.

This time I was paying closer attention. When it came time to reveal his corporate ties, the lecturer simply said, “I have none.”

My God, I thought-a virgin.

Then it occurred to me: Enjoy, because he probably won’t stay one for very long.