At least seven medical-profession associations are among the names appearing on payment-disclosure lists posted on orthopedic-device makers Web sites, prompting some policymakers to suggest the payments are further evidence of how far-reaching industry influence is on the practice of medicine.
The disclosures, posted late last month, were mandated as part of a recent settlement that Biomet, DePuy, Smith & Nephew, Stryker Corp. and Zimmer Holdings reached with the U.S. Justice Department on charges they created phony consulting deals to pay physicians to use their orthopedic devices (Oct. 8, p. 6). The devicemaker settlement was the second-largest federal healthcare settlement in the governments fiscal 2007, according to a new report (See story, p. 16).
While industry relationships with individual physicians were the focus of the influence-peddling investigation, the appearance of medical-profession organizationswhich together collected up to $1.5 millionon the lists should also prompt concern, said David Rothman, director of the Center for Medicine as a Profession at Columbia University.
These organizations are saying that when a surgeon receives compensation from a devicemaker or pharmaceutical company it presents a potential conflict of interest, Rothman said. But youve got those same organizations taking money (from the industry). In fact, theyre taking a substantial amount of money, and many of these groups write guidelines (on appropriate practitioner-industry relationships). So, the question is: What are their rules about conflict of interest for leadership that may be on guideline committees?
Among the recipients of industry funds within the past year are the American Academy of Orthopaedic Surgeons, American Association of Hip and Knee Surgeons, American Orthopaedic Association, American Osteopathic Academy of Orthopedics, American Society of Orthopaedic Physician Assistants, National Association of Orthopaedic Nurses and National Association of Orthopaedic Technologists.
A number of regional and state professional associations also appear on the lists.
I think its a very good point to ask: How do associations involved in setting guidelines that affect patient care make sure that (their) taking money from industry presents no conflicts of interest? There needs to be a firewall between those who make the guidelines and industry, said Sharon Levin, associate executive director of the Permanente Medical Group and an adviser on the guidelines committee that created industry disclosure and access rules for the California-based managed-care provider.