Today's (20 January 2008) New York Times has a useful piece about the Conflict of Interest between device companies and surgeons.
Seems that, in the clinically still-murky field of spinal surgery, an awful lot of doctors are implanting devices made by companies in whom their financial interests, now disclosed, were there from the get-go.
What's most disturbing about this saga, though, is the notion that "in the case of the Prodisc clinical trial, as with any clinical research, the doctors were supposed to be acting not as advocates for the product but as objective scientists studying whether the disk was safe and effective."
How is it possible to do both? What are they thinking?
Oh, that's right. They're thinking, I can do well and do good.
But Richard Deyo, MD, of Oregon Health Sciences University, quoted in the Times piece, perhaps says it best:
“The surgeons themselves are guilty of being insufficiently critical of products and techniques they are developing....” More people are interested in getting on the gravy train than on stopping the gravy train.”
Guess the Pogo Effect is now the norm.
Now that the door has been blown open to the seedy underworld of COI in medicine, it's scary to see how much of modern medicine - with the promise of evidence-based, non-biased, scientific practice - is really subterfuge from device makers, drug companies and complicit physicians.
ReplyDeletePhysicians will need to break these entanglements if we ever hope to have the full trust of our patients. However, many physicians are doing just that. The National Physicians Alliance is a multi-specialty organization that brings together physicians who want to restore integrity to medicine. The upcoming Annual Meeting in Houston will have an entire track on conflicts of interest and restoring integrity to the practice of medicine. Beyond rehashing the recent outbreaks of scandals, we're hoping to help practicing physicians find ways to break free of reliance on drug reps for information. It should be a great conference for anyone with an interest in this area.
Chris McCoy, MD