Speak Out: How do you expect the Sunshine Act to impact you/your urology practice?

“I live in Vermont. Our laws are the strictest in the nation. Companies have to pay an enormous fine if they buy me a cup of coffee. We don’t get pens; forget about meals. We don’t get gifts of any kind-no note pads, nothing from pharmaceutical or device manufacturers.

They can pay for our transportation, hotels, and tuition to take a course, but they can’t buy us a meal.

I don’t know whether the fact that that would have to be reported would affect what I do. The reporting doesn’t really bother me. If the course is worthwhile, why should it make a difference? If you’re doing something that’s not legitimate, you probably wouldn’t want that known, but if you’re going for legitimate educational reasons, I can’t imagine why anyone would object to publishing that.

I don’t do any speaking for them. The rules in this state have been so difficult to get paid for that for so long, it just hasn’t been worth pursuing. So we’re in a unique position in Vermont, and it looks like the rest of the country is eventually going to follow suit."

Craig Rinder, MD

Brattleboro, VT

“We’re in kind of a weird situation in our practice in that we don’t have much going on from a sales rep standpoint. They bring samples, but we don’t have a lot of lunches, or, being in a small community, a lot of educational sessions and dinners.

In the last decade, the entire landscape of pharmaceutical sales has changed so drastically. They’ve taken away 95%; will it really hurt to take away the last five?

The biggest issue is declaring your conflicts of interest. If you have to declare everybody who ever bought you a candy bar as a conflict of interest, that’s a big deal because who hasn’t had a lunch somewhere? If you just have to have your name in a record book somewhere, that’s not a big deal, but it’s a major stumbling block if it prevents you from being in this journal or serving on that committee. I’m on the executive committee at our hospital and I have to declare any financial interest. If taking lunch from Astellas is now a financial interest, I guess I would have a problem with that. They’re looking at big things, but if I have to put anything like that on any disclosure I ever do, that’s the problem I have with that.”

Brent J. Morris, MD

Jackson, TN

“Potentially, it could impact whether pharmaceutical companies even put on CME courses. It wouldn’t discourage me from going to a course. Potentially, it could be misinterpreted with people thinking, or trying to insinuate, that doctors are receiving all these perks. When you go to a CME, generally you need to eat.

Sometimes, the public misinterprets or distorts what’s going on to suggest that physicians are getting compensated inappropriately. But we are required to get CME, so we have to go to courses. I’m not going to not go to a course because of that.

But as an example, we did a community clinic in the past and used to get sponsorship from pharmaceutical companies. Then, a few years back, legislation separated sponsorship from drug reps; they couldn’t give grants and we have to apply for formal grants. That interferes with our ability to serve the community as physicians because it limits our ability to get pharmaceutical sponsorships for critically important community educational programs that we want to conduct. Things like this can potentially interfere with physicians putting on educational events.

We are required to get CMEs. As academicians, we do research that we present at meetings, so we probably go more than the normal private physician, but our department reimburses us for that, not pharmaceutical companies, unless you’re putting on a course they’re sponsoring.”

Charles Modlin, MD

Cleveland