Pfizer is one of the world's largest pharmaceutical companies. “Pfizer’s goal is to help people live longer, healthier and happier lives. The path to achieving this goal is through the discovery and development of breakthrough drugs; providing information on prevention, wellness and treatment; leadership in corporate responsibility” (Pfizer, 2007). On a daily basis, appropriate access to patient data for drug development and commercialization efforts is essential (Pfizer, 2004, p.1). Pfizer may obtain and use personal patient data through coupon programs, health fairs, or clinical trials. In all cases, Pfizer must ensure that the data is aggregated and anonymized, or obtain consent from the individual (Pfizer, 2004, p. 1). Pfizer has carefully developed guidelines to combat federal and state laws and regulations. As the law evolves, Pfizer adjusts the guidelines accordingly. When a consumer is asked to provide personally identifiable information, they should be given the opportunity to refuse. “All coupon programs and rebate offers must contain appropriate privacy language and comply with Pfizer consent requirements” (Pfizer, 2004, p. 6). Physicians must “obtain permission from patients before Pfizer personnel may be permitted to observe a consultation, examination, and/or treatment” (Pfizer, 2004). “A physician who provides disease screening services may suggest treatment based on the screening results, but may not prescribe a specific medication or treatment” (Pfizer, 2004, p. 9). The doctor may encourage the participant to report the results to their own healthcare provider. In short, no patient's personal information may be used for any purpose without their explicit consent. Tenet Healthcare Corporation “Tenet Healthcare Corporation, through its subsidiaries, owns and operates acute care hospitals and related health care services” (Tenet, 2007) “On September 27, 2006, Tenet Healthcare Corporation signed a annual update of its ongoing Corporate Integrity Agreement (CIA) with the Office of Inspector General (OIG)” (Jones, 2007, p. 7). Tenet, like many other healthcare organizations, faces “inadequate medical documentation; poorly executed patient informed consent; inadequate patient education; poor doctor-patient communication; absence of medical necessity for the medical services rendered; and poor performance of medical services” (Jones, 2007, p. 8). As part of the CIA, Tenet agreed to measures such as "a clinical quality department, including a chief medical officer, senior officers and clinical quality staff." ; clinical audits; accreditation of doctors; physician privilege; peer review of physicians; evidence-based medicine programs; standards of clinical excellence; utilization management and review; quality measures; and other quality improvement measures” (Jones, 2007, p..