The Most Influential Doctors listing offers a rare window into the pricey bazaar of medical information that's available to anyone who can pay for it.
But a backlash against the practice has reached the doorstep of the U.S. Supreme Court.
Health information companies IMS Health and SDI Health filed a petition in March to appeal a 3-year-old New Hampshire ban on the commercial use of doctors' prescribing information.
The legislator behind the ban, Rep. Cindy Rosenwald, says the practice drives up health costs without necessarily benefiting patients.
"Somebody is making $2 billion a year off physicians' prescribing habits, doctors couldn't say no to the use of their information, they weren't getting any money out if it, and the state was getting hit with the ever-increasing cost of prescription drugs," she says.
The companies argue that the ban violates their freedom of speech.
"There's a First Amendent right to gather the data, it's lawfully available, and you have a lawful right to package it, synthesize it and put it out in the marketplace," says Rod Smolla, dean of law at Washington and Lee University in Lexington, Va.
One major source of medical information is the American Medical Association, which represents 40% of an estimated 700,000 doctors nationwide but maintains a "master file" of information on most doctors practicing in the USA.
The organization nets more than $40 million in fees each year, about half from hospitals seeking to verify doctors' credentials and the rest from nearly a dozen firms that repackage the information and sell it to their clients. About 22,000 doctors have opted out of the AMA program, says spokesman Robert Mills.
SK&A Information Services in Irvine, Calif., also collects information on about 645,000 doctors, by making an average of 6,000 phone calls every business day, says Jack Schember, director of marketing. SK&A checked the accuracy of the information supplied in the Most Influential Doctors' list.
But many doctors object to the practice. Nearly 25% of doctors have cut back on their availability to drug company sales reps so much that 13% of sales calls -- attempts costing companies about $2 billion -- cannot be completed, says Chris Wright of the consulting firm ZS Associates.
"It's important not to give patients what a drug rep tells you to give them but what the science says," says Rupin Thakkar, a pediatrician in Edmonds, Wash., who has been active in trying to ban the use of prescription information in his state.
He says efforts there are on hold pending the outcome of the New Hampshire case.
The Supreme Court is expected to decide whether to hear the case before its term ends in July.
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