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Globe Editorial

Ethics: Rules reveal doctors’ priorities

January 31, 2010

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When Partners HealthCare implemented strict new ethics rules last April, barring its doctors from giving paid speeches for pharmaceutical companies, some doctors complained about the loss of extra income. Some warned that the guidelines would stifle collaboration between doctors and researchers. But few predicted that a doctor would quit his post at one of the world’s most prestigious medical schools so he could keep traveling and speaking on the drugmakers’ dime. That’s the choice Dr. Lawrence M. DuBuske has made: The allergy and asthma specialist will resign from Brigham and Women’s Hospital and Harvard Medical School this month in order to stay on the payroll of six pharmaceutical companies, including GlaxoSmithKline, which paid him nearly $100,000 to give 40 speeches during a three-month period last year.

DuBuske’s speaking career seems unusually active, so it’s unclear if other doctors will exit with him - or whether the lack of a brand-name appointment will decrease his luster as a speaker. But what’s certain is that restrictive ethics rules are becoming commonplace in the health care industry. Massachusetts implemented new guidelines last spring that ban gifts to doctors from pharmaceutical and medical device companies. The Partners teaching hospitals join others nationwide that have banned all participation in pharmaceutical companies’ “speakers bureaus.’’ These rules offer a vital counterbalance to the pharmaceutical industry’s influence over treatments and prescriptions. They help to give consumers confidence that they’re getting unbiased and untainted medical opinions, and may serve to curb an over reliance on costly name-brand drugs.

But one side effect of stringent ethics rules has now become clear. There will always be some doctors who decide that their top priority is to do no harm to their bank accounts.

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