The big topic at the American Medical Association's annual meeting this summer was not Michael Moore's expose of the health care industry but physician groups' expose of AMA data profiteering.
By selling the names, office addresses and practice types of almost every doctor in the US to marketing firms the AMA makes $50 million a year charged the National Physicians Alliance, American Medical Student Association and Prescription Project which protested at the Chicago convention.
The AMA database, called the Physician Masterfile, is used by Health Information Organizations (HIOs) for data mining and detailing which reveals individual doctors' prescribing profiles to help drug salesmen.
"Doctors are not aware that companies are out there that know every prescription a doctor prescribes," Dr. John Santa with the Prescription Project, a coalition to curb drug companies' access to doctor prescribing information, told the Chicago Tribune. The information is used, "to increase the sales of specific drugs, many of which are no more effective than much-cheaper alternatives," said Santa, an internist at the Portland Veterans Affairs Medical Center, not "to improve quality or safety."
Information about more than 900,000 physicians is included in the AMA data selling scheme, two-thirds of whom are not even members of the AMA.
Last year, the AMA attempted to stop states from banning such doctor data sales--Vermont just restricted the practice and Maine might be next--by self-policing and creating a Physician Data Restriction Program (PDRP) which lets doctors "opt out" of having their data sold.
But why should the opting out burden be on doctors, some of whom have never heard of the program and/or don't belong to the AMA ask Prescription Project physicians who think it should be an "opt-in" program in which doctors consent before their identifying data is sold.
In discussing the doctor data sales on its web site, the AMA sounds like the little boy who didn't hit his brother and even if he did it wasn't hard and even if it was hard, he deserved it.
In the same paragraph it says it "does not collect, compile, license, sell or have access to physician prescribing data" and that it "licenses these data (sic) to prevent fraud and abuse, for physician manpower planning, to verify physician credentials in accordance with the standards of accreditation organizations and by government officials during times of national disaster like Sept. 11th and Hurricane Katrina."
Next it admits that it also sells data to Health Information Organizations "for use by pharmaceutical companies" but submits the organizations "have multiple sources of physician data independent of the AMA,"--so they'd get it anyway.
And besides, the arrangement "enables the AMA to exert regulations on how physician data are used,"--as in We're Protecting Doctors--which of course wouldn't be necessary if the data weren't being sold.
We're also told that selling doctor data facilitates "efficient drug recalls," and "Food and Drug Administration's ongoing post-approval assessment of drug benefits versus risks"--kind of like a private/public partnership but with all private benefits--and it even helped rebuild patient records after Hurricane Katrina.
Of course physicians' legal rights to prescribing privacy have yet to be established and one court in New Hampshire even ruled that keeping prescribing data secret violates drug marketers First Amendment rights.
But few doctors take to sales reps waving prescribing data in their faces and saying, "You promised me last month that you would write more of my product, but based on your prescription volume I can see that you haven't. Why is that?" says an article in Pharmaceutical Executive.
Or being "educated" by salesmen with a high school biology background. ("It's the automatic nervous system," one was heard to say.)
Still, the AMA contends that sales reps perform a valuable service by helping to get "public health and education to the right doctors when new products or devices have come on the market." Funny that's just what the Merck ad on the AMA web site says.