White Coat Notes

1 in 4 Mass. physicians received industry gifts, payments

One in four physicians in Massachusetts received at least one gift or payment from pharmaceutical or medical device companies valued at $50 or more in the two and a half years after the state began tracking them.

The most common gifts were food, while the most lucrative were payments for speaking engagements, consulting or other services, according to an analysis by a Harvard-led research group published online Wednesday by the New England Journal of Medicine.

Between July 2009 and December 2011, industry paid for 14,251 physician meals worth $2.4 million, and made 8,432 payments to doctors for bona fide services totaling $67.3 million.

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Payments were more common among specialists than primary care physicians, with more than half of urologists, gastroenterologists, and rheumatologists receiving a payment of some sort. Orthopedic surgeons had the highest average payment over the 30 months, at $18,446.

More than 90 percent of the orthopedists’ compensation was for speaking fees and other bona fide services, and this category also accounted for the vast majority of payments to psychiatrists and most internal medicine specialists.

State and federal laws passed in recent years have required more transparency about the financial relationship between doctors and drug and device companies. Massachusetts in 2008 required reporting of such industry payments for services and banned most gifts and free meals. Many of Boston’s teaching hospitals and medical schools introduced their own restrictions.

The Legislature in November, under pressure from industry and restaurants, loosened the ban to allow for “modest” gifts and meals. The authors, led by Dr. Aaron S. Kesselheim of Brigham and Women’s Hospital and Harvard Medical School, found a decline over the study period of free meals given to doctors. But they predicted that trend could reverse because of the change in the law.

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