When it comes to writing research papers, doctors are the medical equivalent of journalists. In the ethics department, the two often couldn't be further apart. Few news organizations would put up with a journalist reporting on products while taking money from the manufacturers of the products. But in the world of health care, that's the way the game is played and the head of health care organizations often don't seem to have much of a problem with it.
A couple of stories in the news today underscore the point.
The Milwaukee Journal Sentinel reports today on the relationship between Medtronic and Thomas Zdeblick, the chairman of orthopedics at the University of Wisconsin Madison medical school. He received more than $25 million in royalties from the company since 2003, covering the time when the University of Wisconsin Hospital spent $27 million for Medtronic spinal products
"I really don't know how you would manage that conflict of interest," said Jordan Cohen, a former president of the American Association of Medical Colleges. "It (his financial relationship with Medtronic) is bothersome."
Cohen, a professor of public health at George Washington University, said it would be
What does a conflict of interest look like? It may well be a research paper touting the benefits of a product without disclosing the author's financial interest in the product, the paper says:
Consider the issues involved in a single 2003 study authored by Zdeblick and two non-UW doctors who have received millions of dollars from Medtronic. Those surgeons and others with ties to the firm have been criticized for failing to connect the Medtronic spine surgery product BMP-2 with several serious complications in their published research.
The study was published in the journal at which Zdeblick is editor-in-chief. And the study involved another product, the LT-Cage, from which Zdeblick receives royalties. None of his royalties - or those of the other authors - is from BMP-2.
In unusually glowing language, the 2003 study declared the product could become "the new gold standard" in spine surgery - and then the authors went on to say the product was being used "exclusively" at their institutions.
But is it a situation people are concerned about? Take this comment from a reader:
Whats the issue? The guy is well regarded in the industry. The relationship is disclosed and he doesnt receive any commissions from products used at UW. This is the exact incentive you want to give people/doctors -- you want the best and you want to give them incentives to come up with new advancements in medicine. An extreme example of media bias that doesnt make sense.
The story comes just a week after the University of Minnesota announced it would not discipline a spine surgeon for failing to disclose his financial relationship with Medtronic in his two published papers presented at a scientific conference.
At the same time, the Saint Paul Pioneer Press has been reporting recently on the cushy relationship between health care institutions and drug companies, which it says involves much more money than payments to individual doctors in Minnesota.
In all of these cases, few officials seem concerned about the perception of impropriety in the relationship between drug/device makers and the doctors/institutions.
Shades of the "Fugitive"!
Nothing complicated about this: doctors should be legally prohibited from taking money from pharmaceutical and medical device companies. There isn't one conceivable argument in support of the current system that doesn't hinge entirely on money without a thought for ethics.
Health care should be a public service, not a money pit for the least ethical among us. Further privatization of health care guarantees higher health care costs but sadly we have a TV network dedicated to that proposition. You can spot their viewers: they're the ones who start hysterically shrieking SOCIALISM every time someone mentions single payer, tighter regulation of food or better nutrition/less junk food.
Truly, half our medical budget is devoted to fixing the damage done by our garbage-peddling food industry.
Thanks for bringing to light a very serious issue that needs to exposed. Health care is not about getting people healthy - it is about greed and money.