We think it is interesting that this past week we have seen a plethora of articles and news stories promoting the Physician Payment Sunshine Act as one of the answers to the nation’s health problems. One example is this weekend’s series in the Philadelphia Inquirer, Implant firms pay doctors millions. This is mostly a re-hash of the September 2007 settlement the US Attorney of New Jersey completed with five orthopedic device manufactures. If you are unfamiliar with the case it provides a good analysis of the basic structure of the settlement.
As part of the settlement the companies disclose on websites their payments to physicians. As discussed earlier this year by one proponent of disclosure laws Disclosure = Wanted for Intimidation, these disclosures will be used by journalist in unflattering stories and by the “legal profession”.
Here is what they found nationwide in 2007: fifty one physicians received more than one million each; 29 Philadelphia doctors received a total of $7.9 million which went to two busiest and most prominent orthopedic surgeons Richard Rothman, MD and Robert Booth, MD both of which receive royalty payments for devices they helped design and one holds 8 patents. At the University of Pennsylvania those payments are disclosed to patients. As part of their treatment they sign a form stating: “I am further aware that my surgeons may receive compensation” from the manufacturer.
Both Penn and Jefferson have policies so that physicians cannot receive royalties from products purchased by their systems.
The physicians are contributing to the development of these devices, and it is only natural that they would be compensated for their contributions.
As part of the article, the solution may be in better disclosure according to quotes from Senator Kohl to the Inquirer:
“Collaboration between device companies and surgeons can lead to medical innovation, so we’re not interested in severing those ties completely” (notice the word completely, sort of like saying we are not interested in severing your leg completely). “Our hope is that requiring these relationships to be transparent will serve as a litmus test for legitimacy”.
Several things came out of the article reading it through lines:
A) The US Attorney of New Jersey and the HHS OIG are now focusing on doctors and smaller manufactures
B) The Cardiac Device industry is getting a closer look (heart device makers have been asked to supply information to the US Senate)
C) One former prosecutor said that the shear size of the orthopedic deals raises questions about whether doctors decisions were tainted.
They also took the time to outline the details of the Physicians Payment Sunshine Act sponsored by Senator’s Kohl and Grassley. This sudden focus on old news (2007 settlement) is not by accident and there will be more such articles in the coming weeks.
For a list of the disclosure of Payments to physicians by the Orthopedic Companies: