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Heart & Vascular Health | Heart Healthy Living
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Do You Trust Your Doctor’s Prescriptions?

Transparency and safeguards matter

When it comes to medications, Americans are skeptical.

Many assume their doctors — and expert bloggers on health sites — prescribe or promote certain drugs because pharmaceutical companies pay them to do so. A 2013 Harris Poll showed only 28 percent of Americans think their hospital is trustworthy.

A little healthy skepticism is fair. Doctors are not all immune to influence. In the past two decades, there has been an increase in industry spending to get doctors to promote certain drugs or medical devices.

However, don’t just assume your doctor takes money for consulting or promotion. Many — including myself — require that any money offered for consulting on drug trials goes to charity. And public policy is changing to give you more transparency about the industry.

When you assess how trustworthy your own doctor or hospital are, keep the following in mind.

More transparency is coming

Congress took a big step in promoting transparency with the Physician Payments Sunshine Act, which went into effect Aug. 1, 2013.

Patients need transparency to know doctors are providing the care that is best for them. Patients also need treatments that improve their health. With the right safeguards in place, patients can have both.

Companies that make drugs and medical devices now must report any payments or items they provide to physicians or teaching hospitals worth $10 or more.

That information will be available to you. On September 30, 2014, the Centers for Medicare and Medicaid Services will release an online database containing the reports for public viewing.

Disclosure is not a cure-all — but it’s a step in the right direction.

Many hospitals require disclosure

Many hospitals have taken their own steps to make disclosure public.

For example, Cleveland Clinic requires doctors to disclose any industry relationships or funding. You can find such disclosure on every doctor’s page in the staff directory listing.

Other hospital systems have similar policies in place. On top of that, there are “watchdog” groups that track such information.

Put the industry in perspective

When it’s appropriate, I am critical of the industry. But I also believe we need a vibrant pharmaceutical industry. It’s where many life-saving developments — from better treatments for heart failure to longer-lasting blood thinners — come from.

That is why doctors devote so much time to studies on the effectiveness and safety of drugs. For example, we are performing a large-scale study to determine which nonsteroidal anti-inflammatory drugs (NSAIDs) are safest for your heart.

It all comes down to patient needs. Patients need transparency to know doctors are providing the care that is best for them. Patients also need treatments that improve their health. With the right safeguards in place, patients can have both.

Tags: prescription drug, prescriptions, Sunshine Act
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Steven Nissen, MD, is Chairman of the Department of Cardiovascular Medicine at Cleveland Clinic. In 2007, TIME Magazine named him “one of the 100 most influential people in the world.”

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We welcome your comments. However, we cannot provide a medical opinion without an in-person consultation. To learn about Cleveland Clinic services available to you, please fill out our WebMail form.
  • GeorgeBMac

    Ultimately, it’s up to the physician what he does with the information as well as gifts supplied by the drug industry.

    It’s not all bad – as many seem to assume. (But neither is it all good and OK either !)

    Like any industry, there are those you can trust and those you can’t.

  • Karen

    Personally, I’m more concerned with where my generic drugs are coming from and whether they require the same QC/QA that we do in the US. I don’t understand how America can allow generics from third world countries and not require the same level of QC/QA that we require of our own drug companies. It is scary.

  • Cathy Morgan-Gilmour

    Are statins really necessary? Is cholesterol really a cause of heart disease and strokes?

    • The_Beating_Edge_Team

      Cholesterol is one factor that contributes to heart disease and stroke. Statins are not needed for everyone, but in some circumstances they are recommended.

  • Afraid after trusting.

    For many years despite my telling various Drs. “NO” They insisted upon prescribing RXs that left me in terrible PAIN: Statin=Baycol left me w. Debilitating Muscle pain. I did not want Statins: had no family heart history, only high Cholesterol. Later CRP Labs indicated No Inflammation. Then same & other Drs. Prescribed RX Antibiotics in Fluroquinolone Family: LEVAQUIN, AVELOX, CIPRO. I had NO SERIOUS INFECTIONS! Left with horrible TENDON PAIN & Non-Diabetic PERIPHERAL NEUROPATHY. Am in daily chronic pain. Am AFRAID to see Drs. Tried at least 10 since 1997. All poisoned me. Medical records altered & with omissions. When will paients be protected from SOME Doctors. This area seems rampant w. Drs. who throw strong antibiotics at Patients who have No Infections or minor illnesses.