Thursday, November 01, 2007

Consultant fees ,bribes or kick-backs to academic othro surgeons?

Medical ethics news seems to get worse and worse. Health Care Renewal refers to articles on orthopedic device manufacturers paying-in some instances-unbelievably large fees to orthopedic surgeons. The nature of what they did to earn such fees is let to the imagination but four orthopedic device manufacturers were charged with violating federal anti-kickback laws by paying orthopedic surgeons to use their products.

Sites that list in detail the physician recipients can be found on the Health Care Renewal blog. Perhaps the most striking payment was for over six million dollars to the head of orthopedics at Brighams and Women's Hospital. There were 21 instances of physicians receiving one million dollars or more from one manufacturer.

Certainly, physicians can perform various legitimate consultative activities for drug and device manufacturing companies and we do not know what the fees were for but the accusations of receiving kick-backs delivers still another blow to the prestige and reputation of physicians in general.

Earlier I wrote about the accusation of renal doctors receiving rebates for the use (and some would say the overuse) of erythropoesis stimulating agents in patients with renal failure. I have also commented on the accusation that oncologists were profiting from the in-office administration of chemo drugs and that such profit may have lead to the inappropriate use of such drugs. From my positive personal associations with renal docs and oncologists I had no reason to believe those accusations and did not want to believe them but some who commented to my blog believed otherwise. No doubt many in the lay community will apply the adage "where there's smoke, there's fire" to this most current revelation about money exchanging hands.

Several years ago my brother-in-law after paying $90 for his first month supply of Zocor commented that his physician was probably getting a kick-back from the drug company. I self-righteously told him that sort of thing doesn't happen. I am not sure what I would say now.

1 comment:

Anonymous said...

Doc- wondering what your thoughts are on the new World Cancer Research Fund recommendations for preventing cancer. They say there is "convincing" evidence that obesity causes cancer and that many diet choices can prevent it. However, all the data is from epidemiologic studies. How "convincing" can any recommendations be if they are based on epidemiologic data with small relative risks?