One More Payment to an Academic Health Care Leader by an Orthopedic Device Company

An article in the Detroit Free Press provided another telling anecdote about the many, often huge payments to orthopedic surgeons that some orthopedic device manufacturers just revealed. (See previous posts here and here.)

Michigan orthopedic surgeons and health systems performing hip and knee replacements received more than $1 million from five medical device companies, according to a landmark settlement of allegations of kickbacks by the companies.

Michigan's highest-paid consultant in 2007 is Dr. Lawrence Morawa, an orthopedic surgeon in the Oakwood Healthcare System and newly named chair of orthopedic surgery at the Wayne State University School of Medicine.

Morawa received $275,000 to $375,000 from Stryker Orthopedics Inc., a New Jersey subsidiary of Kalamazoo-based Stryker Corp.

Stryker said Morawa received the money for royalty income from inventions, consulting income, research and reimbursements for travel. Morawa said in a statement to the Free Press that the compensation was for 'my time and intellectual property to help design and refine products that improve patient outcomes.' He said he used products from many manufacturers, not just Stryker, 'depending on the specific patient need.'

I have not yet seen any comprehensive analysis of the information provided in the lists released by the device manufacturers. My quick perusal revealed a number of prominent academic orthopedic surgeons who received very large amounts, some much bigger than $375,000.

Academic physicians and surgeons take care of their own patients, but can widely influence health care and the care of many patients by their teaching of trainees, and their talks, publications, and national and international visibility.

The case of the orthopedic device manufacturers' payment suggests that even more academic leaders get even larger payments from health care corporations than was heretofore believed. This suggests that the influence of such corporations on health care is even greater than was heretofore believed. And how many more hidden payments have yet to be revealed.

At the very least, the argument gets ever stronger to require full disclosure of all payments by health care corporations and other organizations with vested interests in health care to physicians, health care academics, and other health care decision makers. Obviously, up to now, such disclosure has been honored more in the breach.