Public shaming

A number of Filipino doctors have been in the news for alleged unethical practices, involving among others ownership of shares in pharmaceutical companies, prescribing and selling branded medicines and drugs, and the imposition of excessive doctors’ fees.

Sen. Raffy Tulfo himself admitted that many of these are not illegal, because there is no law that prohibits these practices, except for the Generics Act which requires doctors to write down in the prescription the generic name of the medicine first and then a brand name at their option.

The Food and Drug Administration (FDA) also requires doctors who own shares in pharmaceutical companies and pharmacies to disclose their ownership.

Tulfo also cited the Mexico City Principles for Voluntary Codes of Business Ethics in the Biopharmaceutical Sector, a set of guidelines for ethical business practices in the pharmaceutical industry which is being implemented by the FDA.

It says that health care professionals must not be improperly influenced by pharma companies and nothing should be offered or provided by these companies in a manner that inappropriately influences a healthcare professional’s prescribing practices.

Meanwhile, the Revised Code of Ethics for the Medical Profession of the Philippine Medical Association provides that professional compensation should be reasonable and shall be guided by the patient’s capacity to pay, the standard fees in the community and other factors such as physician’s expertise, the difficulty of the case, and the patient’s co-morbid conditions.

It also states that physicians shall not participate in any marketing strategies including special prescription pads, rebates, commissions, or raffles.

The Philippine College of Surgeons, Philippine Association of Thoracic, Cardiac and Vascular Surgeons, and the Philippine Wound Care Society recently condemned the public shaming of members of the medical profession, saying questions of professional fees, should be addressed through proper and respectful channels, adding that their own organization has a mechanism of holding their members accountable and that any dispute or allegation should be resolved through dialogue, mediation, or the appropriate legal and regulatory bodies, not through trial by publicity, especially on social media.

Meanwhile, the Philippine College of Physicians stressed that irresponsible social media posts spreading unverified information and unfounded claims against physicians not only tarnishes the reputation of individual doctors but also erode public trust in the medical profession.

The Philippine Medical Association also condemned the social media public shaming of a surgeon physician, saying that each doctor has the right to determine the worth of his services rendered taking into account the complexity and type of services rendered and level of expertise of the physician.

These statements were issued following a social media post by former journalist Mon Tulfo criticizing on Facebook a Philippine Heart Center doctor for charging his friend’s mother P85,000 in professional fees. But various medical professional groups said that the fee was actually lower than usual since the patient was treated for over 20 days.

For his part, Sen. Raffy Tulfo last year alleged that some doctors were involved in a multi-level marketing scheme of Bell-Kenz Pharma, a company whose shareholders include doctors, and that doctors who were part of the MLM were receiving incentives for promoting Bell Kenz medicines.

Bell Kenz officials and representatives have denied the allegations, saying that such marketing scheme applies only to their medical representatives and that they have never recruited doctors into the scheme not have medical professionals received lavish gifts from the company, except for sponsorships to conventions for educational advancement of these doctors which is allowed.

They also denied that doctors, to their knowledge, have been prescribing the brand names of Bell Kenz medicines instead of the generic names as required by law.

On the alleged MLM scheme, it said that these medicines are available in all leading drug stores.

Bell Kenz emphasized that their medicines are priced up to 30 percent lower than comparable brands, thereby generating significant cost savings on patient care.

Is there a law that prohibits doctors from owning shares in pharma companies? None. Is it unethical? Will it result in the doctor-investors overprescribing? How is that different from doctors owning shares in hospitals, pharmacies, and other medical facilities which is not prohibited and not considered?

In any profession, reputation and integrity are important. If there are alleged violations of laws and ethical standards, then they should be raised in the proper fora and those questioning these professional’s practices should not resort to trial by publicity or social media/media shaming because once reputation is tarnished and integrity is questioned without sufficient and factual basis, these are difficult if not impossible to repair and restore. Once trust is eroded, it is impossible to regain. This call goes out to our legislators too.

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