Two Maine physicians, Drs. Ben Schaefer and Bethanie Picker, threw in their hats Monday for LD4 in the op-ed pages of the Bangor Daily News.  LD4 is a law passed in Maine earlier this year that gives doctors a choice to keep their prescribing data from being sold to the pharmaceutical sales force via a nifty process called “data mining” (more on that here and here).  The law is being challenged by industry and the middle men running the sale, who claim medical data is the ticket to better health care. 

Schaefer and Picker say yes, data matters, but so do the hands it is in, and they think prescribing data in the hands of sales people with a Lipitor quota to hit is hardly a guarantee of better medicine or patient care.

If Dr. Schaefer’s name looks familiar, you might have seen his letter to the editor in the Wall Street Journal on Saturday.

“Frankly,” he wrote, “I am tired of hearing Big Pharma complain. There may be a crisis looming, but it is largely a self-made crisis and not even close to the one faced by patients who haven’t been able to afford their medicines in recent years.”  If you are a subscriber, go here.  And he and Picker have been in the op-ed pages before in support of stopping the sale of prescriber data for marketing purposes.

What to make of Dr. Schaefer’s rising word count? Well, the conversation around conflict of interest is certainly not a new one, but one could argue (and we will) that the debate is heating up. PostScript takes it as a good sign that doctors are joining in as vigorously as Picker and Schaefer have. 

After all, medicine is not just practice but an idea, an ethic, and a critical, if broken, social contract.   Healing patients is good, yes, but healing them and also thinking about how it’s done and how it could be done better – in this case, without the over-the-shoulder help of the pharma’s sales team – is even better. 

Schaefer and Picker are both members of the National Physicians Alliance, a great group of docs and ally of the Project.   Other NPA docs in print (and online) are Daniel Carlat,  Howard Brody, and NPA blogger Chris McCoy.  But the common thread here is not the newsprint, but their self-made roles as citizen MDs.

Let’s be clear; we’re not talking about the long-standing tradition of the doctor-writer, the William Carlos Williams way of putting down the art and science of medicine in poems, or of Atul Gawande, who writes with a definite audience in mind (readers of The New Yorker, for one). 

Instead, Schaefer, Picker, and other physician-advocates like Carlat, Brody, Joshua Sharfstein and Roy Poses, to name just a few, are writing because they believe there are things that need to be said, opposed, and fought for.  As those practicing medicine, they have the twin right and responsibility to do it. And, let’s face it, the letters behind their name to get heard.