Disclosure and Transparency: How do we know just who is giving us advice?

Reading the recent conversations regarding the non-disclosure by both ABC and Dr. Lillian Beard about Dr. Beard’s significant ties to formula manufacturing, I wondered how we, as consumers, are ever to know whom to trust when we are given advice by “experts.”

I know I’m not the only one.  According to the Pew Prescription Project, 64% of Americans say that it is important to know their physician’s financial ties to pharmaceutical companies, and most disapprove of even small gifts to their doctors.  In addition, the majority of those polled believe the pharmaceutical industry has a large influence over prescribing decisions.

In addition, 71% of Americans would support legislation that requires pharmaceutical companies to report gifts to doctors.   We have the start of that legislation.  Contained within the Senate version of healthcare reform, the version that ultimately passed and became law, is the “Physician Payments Sunshine Act.”  Introduced by Senators Grassley (R-IA) and Kohl (D-WI), it requires that drug, biologic and medical device manufacturers to report certain gifts and payments made to physicians. The information will be made available to the public on a searchable website no later than September 20, 2011.

There’s room for improvement though.  The legislation doesn’t cover infant formula.  It only covers physicians and not other providers.  And it allows the public to learn about the relationships their physicians have with pharmaceutical companies, but it is still incumbent on the patient to do the research.

At meetings where physicians receive continuing medical education credit, the presenter has to start the presentation by disclosing any relevant financial ties pertinent to the content of the presentation.  In most other cases, as we saw with Dr. Beard and ABC, no disclosure has to be made.  It may be the right thing to do, but it isn’t required.

We have spoken up.  This year, the Executive team of the Section on Breastfeeding for the American Academy of Pediatrics along with each of the AAP Chapter Breastfeeding Coordinators (most of whom are ABM members as well) introduced a resolution to the AAP leadership that addressed our concerns related to potential conflicts of interest that the AAP may have with our sponsors.  That resolution passed and we hope to see the AAP reevaluate its position with industry.

But we need to do more.  This lack of disclosure and transparency from experts is a Best for Babes “Booby Trap.” We need to get the relevant information out to new moms so that they can make an informed, commercially unbiased decision about how to feed their child.

We can ask our legislators to expand the current Physician Payments Sunshine Act to include infant formula.  We can ask them to place responsibility on the physician to disclose their relevant ties when they are asked for their expert opinion.

To find and contact you Senators and Representatives start here — http://www.usa.gov/Contact/Elected.shtml — and then keep going.

Dr. Jennifer Thomas is a pediatrician in Wisconsin and is Chief of the America Academy of Pediatrics Chapter Breastfeeding Coordinator Leadership Team. She shares her expert advice on breastfeeding and pediatric care at DrJen4kids.com