Cambridge doctor says solution to opioid crisis 'extremely simple'

CBC News | Posted: October 27, 2017 9:00 AM | Last Updated: October 27, 2017

Doctors shouldn't be paid by drug companies if they are lecturing other doctors, Dr. Paul Cary says

Image | Money and prescription

Caption: Dr. Paul Cary says the College of Physicians and Surgeons of Ontario could stop the opioid crisis if it banned doctors from lecturing other doctors if they were being paid by drug companies. (Getty Images)

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A Cambridge doctor says the College of Physicians and Surgeons of Ontario has failed to stop the opioid crisis when the solution is "extremely simple."

"Call a general meeting and pass a ruling that doctors are no longer to accept money from drug companies if they are teaching other doctors," Dr. Paul Cary told CBC News. "That would instantly stop the whole process, and then we would be back to an era of what medicine was like when I started."

Cary said as much to the College earlier this year, when he sent a letter to the editor of its quarterly magazine Dialogue. The letter was published in the latest edition, published this October.

In it, Cary says the practice of drug companies paying doctors has "killed or ruined the lives of hundreds and thousands of Canadians," and that "Canadian physicians and their patients deserve better."

Drug companies routinely pay doctors to sit on advisory or consultation boards, to participate in industry research and to make presentations at continuing education events. With the college's knowledge and approval, they also provide doctors with teaching aids and drug samples.

I don't know whether what he's telling me is 100 per cent bias free or whether he is actually receiving money from a drug company and is biased. - Dr. Paul Cary

Physicians like Cary, who aren't paid by drug companies, attend these continuing education events and are often unaware that the lecturer may have a sponsorship behind them.

"In the old days, it used to be a doctor used to stand up and give you the benefits of his clinical experience, and that was very valuable," Cary said. "Now, they put up slides that have been made by drug companies. They follow a format that's obviously a marketing formula."

In this way, Cary said, pharmaceutical companies like Purdue Pharma — which introduced OxyContin in 1996 — was able to aggressively market its drug in Canada.

"The problem is for a practicing doctor like me, is that I don't know the ones that are taking the money," he said. "I don't know whether what he's telling me is 100 per cent bias free or whether he is actually receiving money from a drug company and is biased."

Disclosing payments

In September, the provincial government introduced legislation that would make it easier for doctors and patients to see who was receiving money from pharmaceutical companies.

If Bill 160 passed, Health Minister Eric Hoskin said the government would make it mandatory for drug companies to disclose payments made to doctors.

In an email to CBC News, a ministry spokesperson said drug companies would likely be required to start tracking "the required information" in 2019, and the information would be made public in 2020.

Not far enough

Cary doesn't think these efforts go far enough, nor does he expect they will address the underlying problem.

"You have to ask yourself, well, why are you allowing them to take money in the first place? You know? It doesn't make any sense. It's completely mindless that you would do that."

Cary said the way to solve this problem and stop the proliferation of opioid prescribing in Ontario is to stop allowing doctors who are paid by drug companies to lecture other doctors.

It would be a "simple thing," he admits, but he is convinced "we would get a whole lot better lectures and a whole lot cleaner medicine."