How closely tied are professional medical societies to drug and device makers? Just how much money do some receive? And how obvious is the spending at annual meetings? The answers - some have very close ties, get lots of money and the outlay can be enough to burst a blood vessel. Take the Heart Rhythm Society, which is holding its annual to-do in San Francisco this week.

For instance, Sanofi-Aventis shelled out a total of $351,00, which was divided this way: $110,000 on programs & guides; another $110,000 on educational support; $96,000 for exhibit space; $25,000 for ‘turndown service,’ and $10,000 for bag inserts and cards. Similarly, Johnson & Johnson spent $386,750. Here’s how: $275,000 for exhibit space and lounge;s $36,000 on educational support; $25,000 for banner ads; $20,000 to distribute newspapers and $15,000 on glass clings.

Their logos and others - such as St. Jude Medical and Medtronic - can be seen on hotel key cards, the side of buses rolling by and even carpeting on the convention floor. These are all part of the promotional opportunites that generated some $5 million during the society’s four-day event last year, according to ProPublica, which dissected industry spending for the latest conference (look here and here).

Why might this matter? Drug and device makers target docs in hopes of selling products, of course, and the barrage of advertising and tchotchkes at these events is hard to miss. This sort of promotion, however, has been raising questions about the extent to which, if any, medical practice may be influenced as a result. How so? Groups such as the Heart Rhythm Society set national guidelines, lobby Congress about Medicare reimbursement issues, and research funding and disease awareness.

This debate and accompanying concerns are not new. More than two dozen medical societies - including the National Alliance on Mental Illness, the American Medical Association and the American Cancer Society - have been the subject of scrutiny for the past two years and have prompted increasing calls for these organizations to disclose their funding (back story here).

Last fall, The Chronicle of Philanthropy found the organizations that have been the subject of a past Senate probe receive more than $100 million in aggregate each year from drug and device makers in the form of donations, advertising revenue, exhibit fees, corporate memberships, and support for continuing medical education (see this and look here to see how much money each organization received from drug and device makers, and reported last month to the Senate Judiciary Committee).

The conference spending is among “the subtle ways in which the companies and professional societies become partners and - wittingly or unwittingly - physicians become agents on behalf of the interests of the sponsoring company,” Cleveland Clinic cardiologist Steve Nissen tells ProPublica. “It has a not very subtle effect on medicine.”

For its part, ProPublica writes that, last year, nearly half the $16 million the Heart Rhythm Society collected last year came from drug and device makers (look here). Still, the group denies that industry money buys influence, but is essential to developing new treatments. However, the organization yesterday disclosed a new policy requiring more detailed disclosure of board member industry ties - 12 of 18 are paid speakers, consultants or hold stock.

“This is our business,” Bruce Wilkoff, the incoming RHS president tells ProPublica. “We either get out of the business or we manage these relationships. That’s what we’ve chosen to do” (read more here).

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