July 12, 2007 — Recent protests at the American Medical Association (AMA) annual meeting in Chicago brought to the forefront the fact that the AMA has begun disclosing information in its Masterfile, or physician database, to pharmaceutical companies, as reported in a Chicago Tribune news article published June 24. Although the Prescription Project, the National Physicians Alliance, and the American Medical Student Association (AMSA) are protesting the “sales” of these data for pharmaceutical marketing purposes, the AMA calls the financial arrangement “licensure” and notes that physicians have the right to opt out of sharing their personal information.

“The Prescription Project, AMSA and the National Physicians Alliance have partnered to bring the practice of data mining into the public eye and educate physicians about the problem,” Robert Restuccia, BA, MPA, executive director of the Prescription Project, told Medscape.

“We are calling on the AMA to stop the practice and on individual doctors who do not want to be complicit in this process to communicate their concerns to the AMA,” Mr. Restuccia said. “We are also calling on state officials to support legislation to end the sale of prescriber level data for pharmaceutical marketing purposes.” The Prescription Project is led by Community Catalyst in partnership with the Institute on Medicine as a Profession and is funded by the Pew Charitable Trusts.

“The AMA has been responsibly licensing its database for 65 to 70 years for all sorts of purposes: medical education, both continuing and graduate, and for marketing and credentialing purposes,” Robert Musacchio, PhD, AMA senior vice president of Publishing and Business Services, told Medscape. “Every hospital in the country uses data from our file to verify that a physician is who they say they are. We do not sell the information, we license it, which means we can control where it goes, to whom it goes, and the manner in which it’s used throughout our contract.”

Since the AMA began compiling physician data in 1906, the Masterfile is now more than a century old and includes approximately 900,000 physicians, about two thirds of whom are not AMA members.

Physicians, Organizations Object to Data Sales

“As a physician, I have no knowledge or control over data about me that is sold in the AMA Masterfile,” Michael Mendoza, MD, MPH, a clinical assistant professor of family medicine at the Pritzker School of Medicine, University of Chicago in Illinois, told Medscape. “I am not an AMA member, and I feel that the AMA has abused my rights to privacy by selling data about me without my consent for commercial and marketing purposes.

“This practice ultimately hurts patients because these data ultimately help pharmaceutical representatives to create highly effective tactics to persuade doctors to improperly prescribe more profitable drugs that have not been shown to be as effective as older drugs,” added Dr. Mendoza, who is also a member of the National Physicians Alliance and Prescription Project. “These newer drugs are more expensive and also contribute to rising healthcare costs, a cost that is passed on to taxpayers and individual patients.”

The massive database contains “information you could obtain from just about any state licensing board Web site,” according to Dr. Musacchio, including the name, address, demographic data, practice type, specialty, medical school and residency training, and licensure and credentialing information on all US physicians — AMA members and nonmembers alike. However, prescribing data are not compiled by the AMA.

The AMA has issued licenses to peruse the database to about 10 different licensees, some of which have various business arrangements with pharmacies.

The pharmaceutical companies “take our data as well as [data from] several dozen other databases and combine them together with information that they receive from pharmacies, and they put together a picture of physicians’ prescribing habits — by zip code, by specialty, by individual physician — and they use it for their planning and marketing purposes,” Dr. Musacchio said. “It benefits physicians in that they receive targeted visits from pharmaceutical reps as opposed to broad visits, so that physicians don’t receive visits concerning therapeutics that they might or might not be interested in. This is not really a patient issue, from our perspective, but I would ask how it would hurt patients if it’s designed to provide physicians with information about therapeutics.”

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