For years, doctors didn't bother to reveal profitable ties to drug and device makers: either no one questioned them or the relationships were hush-hush. But now that those financial arrangements are the subject of a congressional investigation and debate among medical journal editors and patients, some physicians are voluntarily cutting their pharma ties, and one of the country’s top medical centers has vowed to come clean by disclosing the names of their docs doctors on drug company payrolls. The goal: to avoid charges of masking potential conflicts of interest.

The Cleveland Clinic today began naming names on its Web site, a move first reported by the New York Times. Four-hundred of the clinic’s 1,800 physicians reportedly have such cozy biz relationships, according to clinic spokesperson Eileen Sheil. Patients deserve to have the info so they're comfortable that their care – and not potential profits —  is the sole criteria of their treatment, Guy Chisolm III, the clinic’s conflict-of-interest committee chair, told the newspaper.

Sen. Charles Grassley (R-Iowa) launched an investigation last spring into why prominent psychiatrists at Harvard, Emory and other universities didn’t disclose the money they received from drug companies. He introduced legislation last year that would require companies to disclose payments they make to doctors; as of last year, five states had such laws in place. According to the Times, pharma giants Merck and Eli Lilly plan to begin releasing the names of docs on their dime next year.

Watchdogs commend the Cleveland Clinic for revealing these relationships, but is the policy one of full disclosure? Doctors are only required to fess up if they get $5,000 or more a year in fees or royalties, and they don’t have to list  exact dollar amounts, though such a requirement may be added later, Sheil says.

Cardiologist Steven Nissen, a prominent Big Pharma whistleblower at the clinic who questioned the cardiovascular safety of the diabetes drug Avandia and the arthritis medication Vioxx, tells that he has ongoing relationships with Roche, Sanofi-Aventis, Astra Zeneca, Novartis and Pfizer. He says those relationships are "all going to be listed" in the clinic's site as part of the new disclosure program.

"I'm excited about it and it's something I'm very proud of," Nissen says. "I've had a longstanding policy that doctors should work with industry. We can help to develop new therapies by working in public-private partnership but the arrangements should be publicly disclosed." His profile currently says that he contributes all drug consulting fees to charity but does not name the specific companies he works with.

Nissen's name has been floated as a possible Food and Drug Administration (FDA) chief, but he wouldn't comment today about whether President-elect Obama has approached him about the job or if he's interested in it. Last year, without saying he wanted the post, Nissen told the Times, "I want to fix the FDA."

Image by iStockphoto/Oleg Prikhodko