Conscious Moral Antennae

"We have clear business conduct policies and practices that are known to those who work and practise at St.Joseph's. This includes how we relate to all businesses who supply and serve our organization."
Kathy Burrill, spokeswoman, St.Joseph's Health Care, London, Ontario

"St.Joseph's and Western take these allegations very seriously and have jointly appointed an outside investigator. We will not be commenting further while the investigation is ongoing."
Keith Marnoch director media relations, University of Western Ontario

"The education of medical students should be based on the best clinical information available, unbiased by the commercial interests of industries marketing pharmaceutical or other health products. Practices that were once entrenched into medical culture should no longer play direct or indirect roles."
York University research study

"Clearly, they want to sell a product, and there is an overlap because they have a product that we want to use. Some companies are more aggressive than others, but that's where professionalism comes into play."
Dr. Allan Slomovic, Canadian Ophthalomological Society

The cost of pharmaceuticals to the Canadian health care system has skyrocketed. Over a 30-year period it has escalated over 15-fold, rising steadily from $2-billion in 1980 to the most current figure available, $30-billion by 2010. In contrast, hospital care which includes drugs used in hospitals and medical care provided in hospital rose five-fold, from $12 to $83-billion over that same time frame.

That figure represents an expenditure under the Canada Health Plan of approximately $836 per individual. The Canadian Institute for Health Information points out that drugs account for the second-largest share of total health care costs after hospitals; 16.4% of the country's total $183-billion health-care bill.

Drugs came in at about $30-billion, while hospitals consumed about $50-billion, in 2009. Of that total in drug spending 85% represented the cost of prescription drugs across the country.


Allegations have arisen that a pharmaceutical company has exerted "undue influence" on the ophthalmology department of the medical school at the University of Western Ontario's St.Joseph's Health Care, in London, Ontario. Both institutions have denied those allegations while treating the charges seriously. They have launched an independent review to be undertaken by lawyer Elizabeth Hewitt who will be meeting with doctors as part of her review.

Her investigation concerns quite specifically a charge of "a pharmaceutical company and potential undue influence within the department of ophthalmology". Without naming the company involved or giving any details of the precise nature of the concerns, nor who might have raised those concerns. None of this was divulged publicly, but the news media has become aware and is pursuing the matter since it is, after all, a matter of public concern.

Those professionals within the hospital's ophthalmology department appear not to be aware of the proceedings. "Those of us not involved have heard that the allegations are serious but the details are being kept very private", said a specialist interviewed. "Rumours are flying but no official word yet". It has long been known that an unhealthy relationship has existed between the drug industry and doctors.

But it is professionally controversial, on both sides of the issue. At one time no one thought anything much awry of pharmaceutical companies courting the interest of physicians by offering them free trips, gifts, free samples. Until it finally dawned that the issue was one that required fixing. Pharmaceutical representatives offering speaking fees and other freebies relate directly to bias-fixing of medical scientists and physicians.

Most university medical colleges, it was recently revealed through a study, have little to no regulation in place with respect to discouraging financial ties between their faculty and pharmaceutical producers. And now, even though that same analysis awarded Western's Schulich School of Medicine and Dentistry the highest marks among 17 Canadian colleges, an investigation is being undertaken.

Researchers from York University concluded that handing out consulting or speaking fees, gifts, drug samples or any other freebies from drug companies most certainly has the potential to affect the outcomes of educational quality delivered by professors. One American study looking at psychiatrists trained before and after residency programs implemented conflict-of-interest rules was telling enough.

Those professionals who had been undergoing their medical training before they and their instructors were subject to conflict rules were more likely to prescribe drugs that tended toward the heavily marketed, brand-name versions of antidepressants, sometimes inappropriately, the review pointed out.

Dr. Allan Slomovic, Toronto-based president-elect of the Canadian Ophthalmological Society, though unaware of the controversy that has arisen in London, commented that eye physicians, like any other medical practitioners, are subject to marketing pressures from drug companies. However, the issue is whether or not the targets, the doctors themselves, are aware of the tendentious practise and that they should be professionally alert to the issue.