Oh My! Part 2

If They Are Going To Take the Money, Make ‘Em Wear It

By

Leonard Zwelling

            Blog
ideas come to me from everywhere. They come mostly from current events in the
news or in our halls, but also from conversations with my readers, emails and
letters and the occasional phone call. But I never thought I would get an idea
for a blog from my doctor. Of course, if you knew my doctor, maybe you wouldn’t
be surprised.

            F.
(stands for Frederic; no one calls him Fred) Lyone (this is what everyone calls him) Hochman has cared for me
and for my family for over 20 years. He is a gastroenterologist with an
appointment at St. Luke’s and Methodist and Baylor. He’s the Chief of Staff at
St. Luke’s. He is a Canadian by birth, but a real Texan now, one of the many
foreigners who migrated to Houston years ago who blessed us with their work
ethic and clinical insight. He also happens to be very funny.

            He
is a brilliant and a masterful clinician. He so good that he has an appointment
in cardiology so that he can help rule out the MIs that are really GIs. There
really can be no better argument for immigration reform than the contributions
bestowed on the Texas Medical Center by people from outside the United States
like Lyone or my cardiologist, Chung-Shin Sung (known to one and all as just
Sung) who not only was my medical school roommate, but also saved my life by
diagnosing what would surely have been a fatal coronary lesion or two when I
had no coronary symptoms. He cathed me because he trusted his putatively
worried well patient with a bizarre arrhythmia (me) even more than his own
judgment which told him I should have been fine. That’s my kind of doctor! They both are and I am grateful for their care.

            I
was up in the Hochman office suite on the 25th floor of the Twin
Syringes (St. Luke’s Towers) on July 10 when the man himself came out of his
office unexpectedly.  I was there
to get the paperwork for my annual lab tests (yes, Virginia, I still get a PSA
BECAUSE, if it goes up I will pursue it with imaging and biopsies, but that’s
another blog).

            We
started talking about politics and he said that he thought that all politicians
should have to dress like NASCAR drivers with logos all over their clothing
declaring from whom they are taking money. Apparently when a driver wins a
NASCAR race he is interviewed while donning several different monogrammed hats.
The duration of modeling the headgear is directly correlated with the amount of
financial support the winner’s racing team derives from the names of the sponsors on the various hats. We have seen this to a lesser extent in tennis and golf,
but you get the drift.

            If
the pharmaceutical, device and biotech industries are going to have doctors on
the take, they can do so, but the docs must wear these logo badges on their lab
coats or scrubs so all of their patients will know from whom they are getting
money. The amount of money determines the embroidered font size on the white
background (or some silly color if you are a gynecologist).

            Personally,
I think this is a great idea. It might mean that some of our faculty would have
to own up to conflicts they have with regard to drug companies supporting their
research programs, but I think I would exempt that from the sartorial labeling
for that money really comes to MD Anderson. As long as there is a contract
between Anderson and the sponsor, the faculty member doing the sponsor’s
research cannot make a boat payment with the money. Potential boat payment
money is my determinant of what constitutes money faculty should not take from
sponsors of their work.

            I
understand that I am a conflict of interest abolitionist and absolutist.
Guilty. I am just crazy enough to believe that we in medicine should be above
all that when it comes to our patients. Since it has been amply demonstrated
that these potential boat payment monies to docs alter prescribing habits, we need to stop taking the money or tell the world from whom we are taking it in an unambiguous fashion. Money
and gifts, including coffee and food for docs not only alter providers’ eating
habits (the last person to feed you because she loved you was your mother.
Consider that the next time you are at a meal sponsored by pharma and stop
taking the pens, pads, and golf balls, too), but also create a relationship
based on a childhood surrogate for love. (I’m Jewish. Food is love).

            Now
recall, if you will, that there have been several sightings of our President
sporting his Aveo jacket at the athletic contests of his children. Once again,
that brilliant member of the NAS and IOM is way ahead of me in disclosing his
allegiance to boat payment suppliers on his clothing.

            He’s
setting an example. Don’t you think you all should follow it? If you are going
to be conflicted, why not do it in style?