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Healthcare

Dallas Docs Make Bank on Pharma and Medical Device Royalties

An interesting data dive from ProPublica in which you, like me, might discover your doctor enjoys having lunch with drug reps.
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A handful of Dallas doctors pocketed more than $1 million last year through royalties, ownership interests, and in some cases, consulting and speaking engagements tied to the pharmaceutical and medical device industries. ProPublica releases its latest edition of a series tracking the connection between the companies that make our drugs and devices and the people who prescribe and use them:

Back in 2013, ProPublica detailed what seemed a stunning development in the pharmaceutical industry’s drive to win the prescription pads of the nation’s doctors: In just four years, one doctor had earned $1 million giving promotional talks and consulting for drug companies; 21 others had made more than $500,000.

Six years later — despite often damning scrutiny from prosecutors and academics — such high earnings have become commonplace.

ProPublica now finds that 2,500 physicians have received at least half a million dollars over the last five years, and another 700 have pulled in $1 million.

In Dallas, a plastic and reconstructive surgeon, a child neurologist, a gastroenterologist, and an orthopedic surgeon are among the doctors who topped seven digits last year alone. I count a dozen over $500,000 in 2018. Most make their money off ownership or investment interests or in royalties or licensing, largely tied to devices. Dallas-based plastic and reconstructive surgeon Gail Lebovic made $10.5 million through Focal Therapeutics, a medical device company where she serves as Chief Medical Officer.

You will have to search through and make your own decision about the degree to which anything untoward is happening here; I don’t think it’s so easy as condemning the highest earners. Doctors thinking up devices and then profiting from that intellectual property is nothing new, but there is potential for conflicts of interest, and data like this gives us a peek at the amount of money at stake. The more concerning trend may be the connection between doctors and pharmaceuticals, where pharma companies are sprinkling hundreds of millions of dollars of influence across the country in bite-size payments for consulting or travel or meals.

That money filters right here to Dallas. My primary care physician, for instance, appears to be very willing to eat lunch on a pharma rep’s dime. He took a whopping 108 payments in the form of food and drink last year and 126 the year before that. The meals were paid for by sales reps spread across dozens of different companies and drugs, several of the top ones treating diabetes (a particularly competitive slice of the market, ProPublica notes). I’m trying to decide how alarmed I should be. ProPublica says nearly every doctor in America has taken at least one payment from a company, in whatever form, over the last five years. But one every three days? I don’t know if I’ll seek a new doctor, but should I contract diabetes, I think I’ll consult a second opinion.

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