When physicians become businessmen and businesswomen, the intersection of clinical practice and business interest can be very dangerous. Just ask the prestigious Cleveland Clinic, which seems to have run a red light (See Special Report).
It all started in December 2005, when Eric Topol, M.D., a renowned cardiologist, was forced out as the head of Cleveland Clinic's medical school. The move came shortly after Topol testified on behalf of a plaintiff in one of the cases against drugmaker Merck over its actions regarding its Cox-2 inhibitor, Vioxx. Not long after, he criticized the clinic's chief executive, Toby Cosgrove, M.D., for the latter's myriad outside business interests.
Cosgrove recently resigned from the board of directors of AtriCure, a medical-device company whose surgical products have been used extensively at the clinic. The clinic is an investor in the company. He also gave up his position as general partner of Foundation Medical Partners, a venture-capital firm that the clinic helped found, which also invested in AtriCure. Cosgrove and another doctor at the clinic failed to disclose their ties to AtriCure in authoring a favorable peer-reviewed article on the company's cardiac-surgery product.
Cosgrove and the board subsequently asked for an outside expert on ethics to review the clinic's conflict policies. It is unlikely-given the conflicts rife in the ranks of trustees, executives and doctors at the famed clinic-that much will come of this review.
For one thing, the chairman of the board, Malachi Mixon, is also bound up in his own web of conflicts. He is the CEO of Invacare Corp., a Cleveland-area medical device company that is a supplier to the clinic. In addition, the clinic and Invacare are investors in NeuroControl Corp., another Cleveland-area medical company, and collaborators on a state-funded project to create a clinical tissue-engineering center that would develop new therapies.
There are many executives who make hundreds of thousands of dollars per year at their day jobs while taking lucre from vendors. They should devote themselves to that work and not to outside interests about which they feel the need to keep quiet.
Todd Sloane is assistant managing editor of the Opinions and Editorials.