Conflicts of interest in vet medicine: A response to PetConnection's question of diclosure
“Sunshine, they say, is the best disinfectant. Disclosure may be more like a lightbulb, but it’s better than making what can often be life and death decisions in the dark.”
Why is it that I find myself quoting Christie Keith more than any other single pet health writer out there? Hmmm…
This morning over at PetConnection she posted yet another savvy piece on veterinary issues; this time on the surprising frequency with which we in the veterinary industry fail to disclose our ties to profit-making entities.
And she’s absolutely right.
In human medicine you'd never see a clinician give a lecture on a drug without fully disclosing his/her relationship with the manufacturer—up front. Not so on the vet side, as she described.
In vet circles some hard and fast "don'ts" should exist when it comes to plugging a backer, but I still see them done all the time!
- As in Christy’s example, there’s the lecturer who doesn’t disclose that she’s in the pay of the manufacturer for the drug starring in her discussion.
- Or how ‘bout the vet who won’t tell you he’s pushing a certain brand of pain medication [exclusively] because he gets freebies from the company for doing so?
- And the researcher who doesn’t tell that Big Guns Kibble funded his well-received paper on canine nutrition—along with his next five projects?
These are bad, bad things that happen in vet medicine. (For the record, they’re verboten on the human side.) They make me crazy. While most professions might consider them unethical, they’re not considered strictly so in ours.
And let’s not even get into the pet food…because while it may not seem so to you, that’s more subtle and insidious, as is the case with these next examples:
- Free dinner and drinks all around from the drug reps? Maybe I’ll place a big order and maybe I’ll never use the drug—ever. But I still got treated to a nice meal along with a discussion of the new drug’s merits.
- So if I go to a dinner discussion next week sponsored by Eli Lilly on the new flea medication Comfortis, am I obligated to make this known to my clients? Hmmm…
- Pizza for my staff while they sit quietly listening to a rep’s spiel on the merits of treating feline heartworms with X? Is that OK or are we hitting a nerve, now, too?
Though I’m not sure what the right answer is for the more understated cases (beyond banning “gifts” above a certain price point as we try to do for those in government), I’m 100% certain that the first three egregious examples should merit license action, as they would in human medicine.
So why does “failure to disclose” happen so freely in vet medicine?
My guess? People don't yet care enough about these things when it comes to pet medicine. “It's just animals we're talking about, after all” seems to be the prevailing sentiment.
Never mind that these “animals” are fueling a thirty some-odd billion dollar market in the US. Never mind that my profession lauds itself for the increasingly high emotional stakes it’s “earned.”
With a higher profile in the media and in the minds of those consumer-slash-pet owners, it's my take that we have a duty to reform our profession to reflect the practices of our more progressive counterparts…before the rippling wave of scrutiny threatens to overwhelm us.
In an insightful comment to Christy’s post, Bernard J. (Bernie) Starzewski added this masterful stroke to the discussion:
“I like the line from the movie ‘The Princess Bride:
'Life is pain. Anyone else who says otherwise is selling something.’”
Brilliant. And honest. Would that we all could be both.
Because it’s true: In a sense we're all selling something, which is why it's increasingly difficult to separate what's a plug and what's not in this world we live in.
Yes, sometimes a Coke really is just a Coke.
But that doesn't mean I'll be 100% comfortable at the Comfortis dinner this week.