WCAAP Member Reflects on Coalition Against Prescription
Data Mining

By Rupin Thakkar, MD
WCAAP Trustee

In 2008, family physician Jeff Huebner and I co-founded and co-chaired the Washington Coalition for Prescribing Integrity. The coalition represented consumer advocates, labor, health plans, pharmacists, and physicians. The WCAAP and the Washington State Medical Association were active participants. The coalition fought hard to ban prescription data-mining, the process by which health information organizations electronically purchase our prescriptions from pharmacies to compile databases that show how many and which medications individual physicians prescribe. The prescribing databases are combined with information from the AMA Physician Masterfile and then sold to pharmaceutical companies. Drug companies then arm their detailers with individual physician prescribing profiles so they can target specific physicians with finely tuned sales pitches and inducements.

Our coalition nearly succeeded in passing a ban on prescription data-mining in Washington state. The bill passed the Senate and won the governor's endorsement, but it failed to reach a floor vote in the House. The primary reason our efforts were derailed in the House is that similar laws in Vermont, Maine, and New Hampshire were being challenged in federal courts. Two Circuit courts made conflicting rulings on the constitutionality of the laws, and subsequently the US Supreme Court weighed in this past June.

Unfortunately, the Supreme Court deemed laws that restrict prescription data-mining as unconstitutional on the grounds that they violate commercial free speech. They essentially note that free speech trumps physician privacy and trumps states' rights to regulate commerce. The argument made by our side was that the First Amendment protects the rights of companies to speak to consumers about their products, but it does not protect the right of companies to monitor their consumers to see whether their sales pitches are successful. We argued the law was not regulating the substance of marketers' sales pitches, but instead was preventing them from using identifying information to influence and reward specific physicians' prescribing behaviors. Our argument did not prevail. In my opinion, the Supreme Court prioritized the rights of large corporations over consumer protections.

Ultimately, the only way for physicians to protect patients from intrusive pharmaceutical marketing techniques may be to completely close our doors to sales representatives and only learn about new drugs from unbiased sources.
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Contact the author: rthakkar@wcaap.org

ALF is Not a Furry Alien Wise-Guy on TV

By Margaret E. Hood, MD
WCAAP President-Elect

ALF is really AAP's Annual Leadership Forum, designed to be a primary communication link between the grassroots and the policymaking bodies of the Academy. Each year the ALF attracts chapter officers, as well as members of committees, councils and sections to discuss resolutions for the full Academy to consider.

My first ALF was in 2009 as representative for the provisional Section of Hospice and Palliative Medicine. I didn't know a chapter from a council. My eyes were opened by the intense experience of 500 AAP members passionately pursuing issues they encounter in their profession.

Returning from my second ALF this year, I want to describe to all our chapter members, generalists and specialists alike, how I witnessed the aims of the ALF.

To draw upon multiple areas of expertise within the Academy to advise and make recommendations to the Board of Directors.
Talk about massive expertise all collected in one room. The ALF supplies the AAP Board with this expertise to help steer the direction of the Academy.

To promote communication and networking among the leaders of chapters, committees, councils and sections.
I attended a Chapter Officers' Networking Session where the topics of discussion were inclusion and involvement of pediatric specialists. We discussed how to access the AAP to help with advocacy, and we learned that Oklahoma's chapter newsletter includes the popular column "Ask a specialist."

To incorporate diverse perspectives in the discussion and debate of leading pediatric issues.
To see a pediatrician's passion in action, just attend a resolution presentation session. Resolutions are burning issues submitted for approval by ALF attendees as suggestions to the Board of Directors. For example, our District VIII submitted a resolution to protect the children of undocumented immigrant parents.

To integrate and promote understanding of AAP strategic priorities and the policy development, education and advocacy functions of the Academy.
Topics discussed were "Children First in Federal Spending," letting the Capitol know that keeping children healthy is cheap, advocacy for prevention, coping with drug shortages, pediatric workforce issues, and the possible future of 2 year old Affordable Care Act.

To provide leadership education and inspiration for Academy volunteer leaders.
I attended a session on High Performance Teams, which was part of AAP's leadership workshops. This was valuable information for everyday functioning of any team.

It is inspiring to witness the movement and involvement of so many passionate pediatricians. I encourage every one of you to attend the ALF at least once in your career.

Intrigued? Contact tnunes@wcaap.org to learn how you can become engaged in leadership opportunities and help shape state and national policies.
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Contact the author: mhood@wcaap.org