Doorstop With AMA President - Education Seminars on Medicines

QUESTION: What do you think comes out of the report?

DR CAPOLINGUA: You know, it actually shows some transparency around the issue of pharmaceutical companies sponsorship of education. It shows a clear declaration of what occurs and it is a good thing to see and certainly we thoroughly endorse the process that has been occurring and it will be interesting to see into the future how things change and develop.

QUESTION: A lot of people would be surprised to see $31 million spent on basically entertaining doctors. How do you see it?

DR CAPOLINGUA: This really is an issue about education for doctors and it costs money to deliver education. The pharmaceutical companies are actually a source of current accurate and most recent information about new drugs, about possible side effects of drugs, and also about new uses for drugs. And that information is important for doctors to have in order to treat patients in a contemporary and appropriate manner.

QUESTION: Why do you need hospitality and entertainment to educate doctors?

DR CAPOLINGUA: Many times the actual educational events are delivered at the end of a long working day in the surgery and I don't think you could say that's it's entertainment by any means if you call a glass of orange juice and a sandwich entertainment. Certainly in my case it's at the end of the day after work you go to a place, a venue, where the education is delivered and some refreshments are offered to you because otherwise I don't think you'd last the distance.

QUESTION: $31 million is a lot of orange juice.

DR CAPOLINGUA: It's a lot of orange juice over a lot of educational events over a lot of doctors over a lot of very important information distributed over time. But I am not here to defend the amount of money. I am here to defend the principle indeed that we have to access education. The education that's delivered by the pharmaceutical companies, the information about drugs, is not really available anywhere else. No-one else is delivering that sort of information. At all times, however, we maintain that doctors must adhere to the AMA Code of Ethics where they will always be prescribing drugs for patients based on the clinical need of the patient and not due to any perverse or other influence.

QUESTION: How important is the transparency that you say this report?

DR CAPOLINGUA: I think the transparency is an excellent thing and to increase that transparency over time ensures that everything is recorded and made available to the public. It makes the pharmaceutical industry accountable. It is about them and not about us, but I think that the Code and the transparency is an excellent issue.

QUESTION: What's the nature of the 52 Code of Conduct breaches that are being investigated?

DR CAPOLINGUA: I am not privy to the information around the Code of Conduct breaches but I am sure that we will be pursuing that over time to see, indeed, what is found.

QUESTION: Are you surprised about the amount of money spent?

DR CAPOLINGUA: There have been projections that the amount of money would be a lot higher than that, so as I said, it's not really about the amount of money, for doctors it's about the amount of education they've been able to access over that period of time.

QUESTION: I am sure you can understand some people are concerned about conflicts of interest and other issues surrounding money - that amount of money changing hands.

DR CAPOLINGUA: No doctor actually makes any money from writing a prescription and I think it's very important that we maintain that separation. When I write a script there is no kickback for me. I write a script because I believe that that is the medication that my patient needs. So for us there is no money, the money is what the pharmaceutical industry spends and that's their business and the Code of Conduct is about them making that business transparent.

QUESTION: Has there been any research done on exactly what the connection between these educational seminars and doctors prescribing habits are?

DR CAPOLINGUA: Over time there's always been some scrutiny around the pharmaceutical companies marketing, and of course marketing and advertising is designed indeed to have an impact and to attract attention, but a doctor will prescribe the appropriate medications based on clinical judgement.

QUESTION: Is there any chance that this would have happened if the ACCC hadn't forced the hand of the Medicines Australia?

DR CAPOLINGUA: I think the action of the ACCC has been very appropriate in demanding this transparency and this accountability, and it is something that the public have been interested in - and perhaps over time it would have evolved because of that public interest - but certainly the action of the ACCC is fully supported by the AMA.

QUESTION: What are the sorts of concerns that the AMA has over Code of Conduct breaches?

DR CAPOLINGUA: Well we're not privy to the information with regards to what the breaches are about. Certainly we always maintain that doctors must adhere to the professional ethics of prescribing without any third party influences. So certainly if there is evidence of that we would be very interested in looking at those issues.

QUESTION: And it's likely to be something along those lines that is being investigated in the near future?

DR CAPOLINGUA: I am not privy to what the breaches are. The Code of Conduct has a lot of parameters that aren't necessarily about what I've described so let's wait and see what they are.

QUESTION: Do you think doctors are more likely to prescribe a drug when they have attended one of these educational seminars?

DR CAPOLINGUA: It actually doesn't work like that at all. I am a general practitioner and let me tell you that it is about having information at hand in my mind as part of my clinical knowledge and expertise when I am seeing a patient, taking a history from them, examining them and then initiating a treatment. Then I choose, in that treatment, the drug that I believe is appropriate for that patient. It's got nothing to do with anything else apart from the education, knowledge and information and my clinical ability to process that to make the right choice for you.

QUESTION: Do you believe that that is applied right across the board?

DR CAPOLINGUA: I believe that - let me tell you that it would be applied right across the board for all the doctors sitting in their surgeries today. Our principle is that we treat the patients based on their needs, not on third party influences.

QUESTION: Do doctors have an obligation to be up to date with all available drugs on the market?

DR CAPOLINGUA: Doctors generally have an obligation, a professional obligation, to be up to date with latest medical information whether it's about drugs, medications, diseases, treatments, or investigative procedures. When you become a doctor it's an ongoing learning curve and a need to keep your information current so that you can do the very best for the patient that's sitting in front of you.

QUESTION: Surely these seminars or education sessions could create an opportunity for a third party influence on wayward doctors.

DR CAPOLINGUA: In actual fact, if you're looking at the College of General Practitioners process for accrediting education sessions for continuing professional development points, the criteria are very clear that the subject that is chosen to be delivered in the educational event has to be absolutely subject of need for education for the GP, separated from any influence of a drug company and the drug company has to have no delivery in the presentation.

So from the College perspective, that's from the doctor's point of view, which is separate to the Code of Conduct and the pharmacist's point of view, we are very keen to ensure that it is education and that that provides us with knowledge to make the right choice for our patients.

QUESTION: $31 million is a lot of education, what's in it for the pharmaceutical companies?

DR CAPOLINGUA: There is no doubt that pharmaceutical companies are out there to expand market and in one way of doing that is to provide information to doctors so that we can make decisions about which drugs are best for our patients.

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