While many say that physicians have an ethical obligation to warn their peers about bad drugs or medical devices, they often do not do so.
Doctors may choose to remain silent for a variety of reasons like the following:
1. They may fear that speaking out could get them sued or believe that a product problem was an anomaly or their fault.
2. Physicians may also have an aversion to reporting. The United States Food and Drug Administration relies on doctors to help monitor product safety by alerting the agency to adverse patient reactions. Many physicians usually do not make such filings claiming that they are too busy for the paperwork. Dr. Robert Hauser, a cardiologist who, along with a colleague, warned other doctors in 2005 about a defective heart implant told the New York Times that, “The standard in the medical community is not to report.”
3. Financial ties to a drug or device maker. Consulting payments have raised concerns about the impact of money on a physician’s decision about which drugs to prescribe or how to interpret research findings and cash can also shift a doctor’s sense of loyalty. George Loewenstein, a professor at Carnegie Mellon University who has studied medical conflict-of-interest policies told the New York Times that, “If someone has been paying you or employing you, it is very difficult to blow the whistle.”
Over time, companies may see an influential physician as an asset who helps develop products and boost sales. For a consultant, breaking those ties can be costly. When Dr. Lawrence D. Dorr, warned fellow surgeons in an open letter in 2008 that a hip implant made by Zimmer Holdings was flawed, he became the subject of a whisper campaign that questioned his surgery skills. Dr. Dorr, a consultant to Zimmer when he wrote the letter, told the New York Times that, “The first thing that a company does is to put out a campaign that a surgeon does not know how to operate,” and added that, “It hurt my practice for a year.”
Physicians have brought problems to the attention of other doctors by conducting research and publishing their findings in a medical journal to help ensure the credibility of study data and protect researchers from random attack. Getting a study published can take a year or two, however. There is currently a need for more immediate ways for doctors to share their concerns.
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