“Whereas a federal employee must follow the general rule that he or she cannot accept anything from a vendor more valuable than a baseball cap, the rules applicable to private physicians limit the companies vying for their favors to spend no more than $100 on a bottle of wine, at any given meal.” the memorandum said. “At training seminars, and in the professional world, the private world and federal world collide, with results creating far greater consequences for those living under the federal rules.”

The Office of the Army Surgeon General/Army Medical Command told U.S. Medicine in a written statement that the sentencing for Davis “is consistent with current Department of Defense policy as found in the Joint Ethics Regulation.” The office also said that ethics training is provided to the Army Medical Department’s employees.

“The U.S. Army Medical Command (MEDCOM) has a vigorous ethics training program which includes training on prohibitions that govern accepting gifts and payments. All personnel — military and civilian — are required to attend annual ethics training,” according to the office of the Army Surgeon General.

Conflict of Interest

Davis’ case stood out, according to the U.S. Attorney’s District office, because it is one of the first cases in the country where both the company and the physician accepting illegal benefits have been sanctioned. In October 2010, Guidant Sales Corp. had to pay $600,000 to the United States in a civil case to settle claims in conjunction with the payments, meals and gratuities made to Davis.

“There is no question but that Dr. Davis committed a criminal offense and that he should have known better, but there is also no doubt that those who plied him with food, alcohol, money and other courtesies knew exactly what they were doing, and why they were doing it,” prosecutors wrote.

In general, the financial ties between physicians and pharmaceutical and device companies have come under greater scrutiny. In the future, patients will have greater visibility over how much and to whom companies are giving food, travel  and other compensation. Under the Physician Payment Sunshine Act passed in 2010, companies in 2012 are required to record physician payments worth more than $10 and to report them by March 31, 2013. HHS will then post the information in a publicly available searchable database starting Sept. 30, 2013.

An IoM report published in 2009, “Conflict of Interest in Medical Research, Education and Practice,” also tackled the issue and recommended that all academic medical centers, journals, professional societies and other entities engaged in health research, education, clinical care and development of practice guidelines should establish or strengthen conflict-of-interest policies.

“Disclosure by physicians and researchers not only to their employers but also to other medical organizations of their financial links to pharmaceutical, biotechnology and medical device firms is an essential first step in identifying and managing conflicts of interest and needs to be improved,” according to a news release on the study.

In that report, the IoM had recommended that Congress should require pharmaceutical, biotechnology and device firms to report the payments they make to doctors, researchers and others involved in medicine through a public website.

“A public record like this could serve as a deterrent to inappropriate relationships and undue industry influence. It also would provide medical institutions with a way to verify the accuracy of information that physicians, researchers and senior officials have disclosed to them,” IOM stated.

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