Transcript Corporate Contributions to Health Organizations – Josh Freeman

Joshua Freeman, MD
Left Forum, 2011
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Corporate Influence on Medicine and Health
Drug and device makers
Insurance companies
Conflict of interest
Support for health organizations
◦ “Non-health related”
◦ Tobacco
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AAFP Case: “Anti-health” corporate support
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Corporate profit taken out of the system
Administrative costs to garner the profit
Should there be insurance companies?
If so, should they be for-profit?
“Bribery” suggestion
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Drugs
◦ High cost of drugs
◦ Variable pricing in different markets
◦ “Me-too” drugs
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Devices
◦ Create demand
◦ Lack of interoperability
◦ “Make the most irritating noise”
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Direct payments to physicians: consultant,
speaker fees
Funding research
Advertising funding medical journals
Heightened awareness
New rules in AHCs, Hospitals, Practices
Decrease in drug “paraphernalia”, samples
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From “non-health-related” businesses
The AMA and Sunbeam, 1997
Public outcry (unanticipated)
Now a Harvard Business School case study
AMA cancelled contract and Sunbeam sued
AMA paid $9.9 M settlement in 1998
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Classic: Tobacco
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Before and after “Doll and Hill”, 1950
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“Food” and drink companies
High-calorie, high-fat, non-nutritive
Major contributors to the Obesity epidemic
Case: the American Academy of Family
Physicians (AAFP) and Coca-Cola
The American Academy of Family
Physicians is partnering with
consumer products companies
to develop robust new programs
and educational materials for
consumers and medical
professionals about making
better choices with regard to
nutrition, physical activity,
emotional well-being, and other
ways to achieve a balanced and
healthy lifestyle
Consumer Alliance Partnerships
The American Academy of Family Physicians is partnering with consumer products companies to develop robust new programs and educational materials
for consumers and medical professionals about making better choices with regard to nutrition, physical activity, emotional well-being, and other ways to
achieve a balanced and healthy lifestyle.
AAFP recognizes that consumer products companies can have significant influence over consumer health. That’s why the AAFP created its Consumer
Alliance program, a strategy whereby the AAFP aims to partner with companies who demonstrate good corporate stewardship and a strategic focus on
consumer health.
FamilyDoctor.org, the AAFP’s award-winning consumer health and wellness resource, is the fundamental core of the AAFP Consumer Alliance. Through
partnerships in the Consumer Alliance, AAFP will continue to expand educational content that focuses on healthy living to help consumers make informed
decisions about nutrition, physical activity, emotional health and prevention of disease.
Partners include:
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Howard Brody addresses justifications put
forward by AAFP for the Coke relationship:
“Premature accusation”
“Wrong not to engage”
“Other party not evil”
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Response by AAFP-President Heim
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Annals of Family Medicine, Jul-Aug 2010
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Conflict of interest does not require
demonstration of favoritism
Analogy to a judge
In the AAFP case, if the final educational material
includes a strong statement against sugary soft
drinks, we will never know whether, absent the
Coca-Cola funding, the statement would have
been even stronger. That such questions will
inevitably be raised shows the conflict of interest
is both present and serious, quite apart from the
eventual contents of the educational materials”.
Is there a strong statement?
Sugary drinks, including soft drinks,
sports drinks and fruit drinks, are the
number 1 source of added sugar in the
American diet. A 12-ounce can of
non-diet (regular) soda can contain 8
or more teaspoons of sugar and over
130 calories. That’s more sugar than
the American Heart Association
recommends for an average American
woman in 1 day!
Skip sugary drinks and choose water instead
This content was developed with general underwriting
support from The Coca-Cola Company
http://familydoctor.org/online/famdoc
en/home/healthy/food/generalnutrition/1005.html
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“Wrong not to engage”
◦ Arthur Schafer noted “…noted the propensity for
engagement with industry, in such discussions,
magically to convert itself into accepting large sums
of money from industry.”
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“Other party not evil”:
◦ The question is whether their interests may lie in
opposition to the interests of the health of doctors’
patients
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Non-polemical article
Heim article non-responsive
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Not only doctors
Are dieticians more trustworthy?
“Partnership” with:
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Hershey’ Chocolate!
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Yum. I guess it is healthful!
Press Release
Hershey Teams Up With
ADA
Monday, July 19, 2010
American Dietetic
Association and the Hershey
Center for Health &
Nutrition Join Forces to
Educate Americans on
Better, Balanced Eating
Healthy Balanced Living
About Consumer Consultations with RDs Click here to learn about how consumers can
receive a complimentary visit with an RD.
About our Collaboration - Click here to
find out more about the Hershey Center
for Health & Nutrition's collaboration with
the ADA.
What RDs are Saying - Find out more about
our recent survey of dietitians and their
thoughts on chocolate's role in a balanced
lifestyle.
The Facts - Click to learn more about "Fitting
Chocolate into Your Diet", "Responsible
Snacking" and "100 Calorie Portions" of your
favorite candies.
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Parallel to national policy
Increase corporate influence (e.g., “Citizens
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Decrease alternative sources of funding (tax
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United”)
dollars)
Increase dependence on corporate “largesse”
Unwillingness to “tax” members (esp with
recession)
Undermines trust (Brody on AAFP)
Joshua Freeman, MD
[email protected]
www.medicinesocialjustice.blogspot.com