Is your doctor on a drug maker’s payroll?

Doctors have long gotten small favors from drug makers: pads with logos, a deli tray sent to the office, tickets to sporting events and free drug samples.

But in recent years, those trinkets have evolved into big money for doctors paid to speak to other doctors about new drugs, often using canned scripts provided by the pharmaceutical companies.

Some of the paid speakers have become high- volume prescribers of the drugs. Some of the drugs are expensive new entries in markets crowded with generics. And some are no better than older, cheaper drugs.

Taken as a whole, the practice has begun to look less like education and more like legalized bribery.

The vast majority of patients don’t know about these fees. If they did, they might wonder whether the doctor was more influenced by patients’ needs or by personal finances. It’s a reasonable question.

Soon, the public can expect some answers. This week, under a provision in the 2010 health care law, drug and device manufacturers began reporting to the government on virtually all payments to doctors, professional groups and teaching hospitals.

A new government website — searchable by the public — is supposed to be running by September. Pro Publica, an investigative news organization, already has created a database of physician fees from companies required to report them under legal agreements.

A Pro Publica report found that since 2009, 15 major drug companies have paid $ 2.1 billion to tens of thousands of U. S. doctors for consulting, speaking, research, travel and meals. The report found 22 doctors who received $ 500,000 or more.

While such outsize payments are not the norm, even smaller fees raise questions about the objectivity of the speaker. As for the objectivity of lesson plans crafted by drug makers that have billions of dollars at stake, do we even need to ask?

Greater transparency might be starting to have its intended effect. In December, GlaxoSmithKline announced that it is moving by 2016 to stop paying doctors for speaking engagements and attending medical conventions. Other giant drug companies haven’t rushed to follow, but it’s a start.

A small group of doctors has come up with presentations on diseases and new drugs, created by experts who aren’t paid by companies. A few states are using them to educate physicians.

Drug makers and doctors insist that industry payments lead to innovations and improved treatment, rather than conflicts of interest. Some collaborations are undoubtedly useful.

But doctors ought to be smart enough to know that parroting a drug maker’s script should be out of bounds. And patients ought to be able to have confidence that when they get prescriptions, they are receiving the best, most costeffective medications for their conditions. The way things are now, patients have reason to be suspicious.

PHOTO DISC Since 2009, 15 major drug companies have paid $ 2.1 billion to thousands of doctors for consulting, speaking, research, travel and meals.