“Earlier this month, a new study uncovered the links between for-profit primary care clinics, Big Pharma and the sale of patient data,” writes Danyaal Raza.Â
“Earlier this month, a new study uncovered the links between for-profit primary care clinics, Big Pharma and the sale of patient data,” writes Danyaal Raza.Â
Dr. Danyaal Raza is a family physician and primary care and health policy scholar at St. Michael’s Hospital and Health Tech and Society Lab member.Â
As a 1990s kid, I grew up watching Saturday morning cartoons. “Transformers” was prime among them. A cartoon about transforming robots from outer space wasn’t just an imaginative children’s sci-fi show, it was a sophisticated marketing campaign designed to sell toys, disguised as children’s entertainment.Â
Now, I’m a family doctor. I’m more likely to spend a Saturday morning immersed in patient care than watching cartoons. Yet, deceptive bait-and-switch tactics are still a part of my professional life.
Earlier this month,  between for-profit primary care clinics, Big Pharma and the sale of patient data. Like the robots of my youth, there’s more than meets-the-eye.
Visiting your doctor is a deeply personal experience. Some of the most intimate details of your life are shared. So important, that we tell medical students a careful collection of patient history will lead to the diagnosis 80 per cent of the time.
However, as chains of for-profit primary care clinics become increasingly common, the privacy of that encounter is bumping-up against profit maximization.
How so?
Health-care organizations act as custodians of medical information that belongs to patients. As health care providers, we hold it — but you own it.
Historically, these organizations have been not-for-profit, or independently owned and operated by doctors themselves. Increasingly, for-profit chains of primary care clinics are entering the picture. This is a problem for many reasons. One of which is the scale at which patient health information can be bought and sold.
The value of patient data held by these chains is valued in the hundreds of millions of dollars. It’s so valuable that middlemen called commercial data brokers seek ways not only to buy and resell this data to third parties, but to use it to develop specialized tools for those same clients.
Their biggest customers are brand-name pharmaceutical companies. They pay data brokers to develop and deploy customized algorithms that are fed back into electronic medical records, held by for-profit clinics.
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What do these algorithms do? They mine records to identify individual patients who can be prescribed a medication that a client drug company sells.Â
At first glance, this may not seem all that bad. If the profit-seeking behaviour of a pharmaceutical company aligns with getting patients the medications they need, what’s the harm?
The track record of pharma’s influence over prescribing is one we know well. The  is one example. We also know visits by drug sales reps to doctors offices and sponsorships of medical conferences result in doctors less closely following treatment guidelines and prescribing more expensive drugs.
Worse still, this study found that patients did not provide consent for the sale of their data to brokers, or for it to be mined by pharma algorithms.
Though this is the first paper on brick-and-mortar clinics, prior research has identified  in walk-in style, for-profit virtual care.
But that doesn’t make it the new normal.
The way companies like Facebook and Amazon use data has sparked a growing awareness of data privacy, control and commercialization. Personal health information is not immune.
We’ve seen this show before. But we can now see through it, and we can take back control.
More than ever, Canadians are seeking access and control of their medical information. Addressing the findings of this study is one way legislators and regulators can respond. It is essential to not only protect the civil liberties of Canadians, but to build trust in the health care services we all depend on.
Dr. Danyaal Raza is a family physician and primary care and health policy scholar at St. Michael’s Hospital and Health Tech and Society Lab member.Â
Opinion articles are based on the author’s interpretations and judgments of facts, data and events. More details
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