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What would your grade school principal have done if he or she discovered that Mr. Boyd, the school janitor, was spending his summers in
As shocking as the revelation that the man who changes your urinal cakes is a sports hero on the other side of the globe may have been, it doesn’t quite pack the same wallop as the $19.3 million Dr. Thomas Zdeblick of the University of Wisconsin Department of Orthopedics and Rehabilitation has received from medical device giant Medtronic.
Through patent royalties, the good doctor built quite a comfortable second source of income. However, UW Hospital rules only require that doctors disclose approximate compensation amounts from outside sources. Zdeblick’s income fell in the $20,000 and over category. This figure caught the eye of Sen. Charles Grassley, R-IA, who requested an explanation for such a gross understatement from the university. The university, to its credit, responded well and defended Zdeblick from any accusation of wrongdoing.
All of Zdeblick’s patients were given the proper forms disclosing the possibility of outside financial interests. Furthermore, Grassley’s implication that the doctor broke his own code of ethics by accepting payment from Medtronic is groundless — and frankly, irresponsible. It appears the bulk of Zdeblick’s compensation was related to royalties on patents he himself holds, rather than insidious incentives meant to stuff every patient that walks through his door full of pacemakers.
Overall, this case by itself is rather unremarkable, save for the unusual amount of dollars involved. Nevertheless, it does serve to call attention to larger issue of the alarmingly close association between doctors and the rest of the health care industry. There is well-founded concern that the lines between doctors and the treatments they administer are becoming increasingly blurred. Don’t you ever get suspicious when the doctor uses a Claritin pen to write your allergy prescription?
Grassley, however, would do well to focus more on systemic reforms such as — ironically — those proposed in a new bill co-sponsored by himself and Sen. Herb Kohl, D-Wis. Don’t let the name fool you, the “Physician Payment Sunshine Act of 2009” has some real teeth. Its passage would mandate that drug and device manufacturers disclose gifts to doctors in excess of $25. Such a bill would be a huge step forward for patient advocates, and would complement moves made by other institutions.
Stanford, among five other universities, has amended its policy to curb the questionable practice of drug and device companies sponsoring classes and seminars that address topics involving specific products they make. Though this may increase costs to doctors as well as the universities themselves, it is a necessary measure to help ensure the integrity of our current medical system. In any case, the companies are still allowed (in fact encouraged) to donate to a general fund, but a critical avenue of influence has been closed.
UW has also joined the movement, even before Grassley’s letter to UW System President Kevin Reilly; UW-Madison was in the process of a project to better inform patients at seven of its clinics and hospitals about possible ties between doctors and the medical industry. In addition to posting signs through the buildings, the university also has patients sign a waiver form acknowledging the possibility their doctor may have financial ties to certain companies within the industry.
This is only the beginning, however. The university’s response to Grassley indicates they are planning on expanding the program to include a database matching doctors to the exact amounts they receive from medical companies that can be available at the request of any patient. Such a step is critical if full transparency is ever to be brought to the medical industry.
Though Grassley may have overzealously targeted an ethical doctor and skilled inventor, his efforts to root out conflict of interest within the medical industry are important to the health of our nation — so long as they are focused on addressing the systemic problem, rather than one or two high-profile cases. At the same time, Reilly and Chancellor Biddy Martin should also be lauded for their farsighted approach to the issue. With poise and tact they managed to say, “Thanks Chuck, but we’ve got this covered.”
Joey Labuz ([email protected]) is a junior majoring in biomedical engineering.
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This article is inane. The tepid point you try to make has NOTHING to do with the unremarkable case you emphasize. Stick to math, Joey.
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Transparency? As if those hospital gowns weren’t thin enough?
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Royalties are often veiled commissions, and the process of amassing large sums of money is much more insidious than simple pen incentives. The champions or experts are intentionally targeted. The device or method is developed, refined or finalized. For his role the Dr. rightly deserves some compensation. However, while the good Dr. feigns an arm�s length relationship by having patients sign forms to acknowledge the possibility of financial ties in his own clinic, he is also very busy writing articles, publishing studies, and proselytizing from every podium available to an expert of his stature. The Dr’s ‘sphere of influence’ is a coveted promotional marketing tool offering a potential bonanza for the company and the Dr. If Dr. Z got $19.3m how much did Medtronic make? And more often than not the Dr and the colleagues he influences are able to gather to discuss their company sponsored studies only because of the generous “education” grants provided by the same companies. This circle of life is a well disguised selling model rivaling Amway. It costs billions of dollars and makes a mockery of science, medicine, and education. Check the cv of a Dr and track his activity since the onset of a patent or royalty arrangement. Innovation is important and the Dr is a valuable partner for the engineer; but unfortunately he is also the quintessential gold mine for the sales and marketing department.