Alarming Numbers Of Surgeons Failing To Disclose Financial Ties

Almost half of all surgeons who made at least $1 million in payments from orthopedic device companies did not publish the relationship in their scientific articles, according to a study released today in the Archives of Internal Medicine. The study, conducted by researchers at the New York-based Institute on Medicine as a Profession (IMAP), is the first ever to use company records to examine the information doctors disclose in medical journals

Increasing numbers of pharmaceutical companies and medical device companies (many as a result of integrity agreements stemming from past lawsuits) are disclosing the sums paid to consultants (i.e., doctors). These payments present a clear conflict-of-interest, of which all patients should be aware before accepting advice from the doctor in question. However, when compared to the information these surgeons provided about themselves in their medical journal articles, almost half “failed” to acknowledge that they had received such large sums.

“The findings raise troubling questions about undisclosed payments or royalties and other fees from medical device companies that could lead to biased scientific conclusions,” says senior author David Rothman, the president of IMAP.

The five companies studied (Biomet, DePuy Orthopedics, Smith & Nephew, Stryker and Zimmer) paid consultants an astounding $248 million in 2007 for various services. While many of these constitute legitimate, ethical payments, many can become an issue when the doctor in question advocates for a certain product or procedure the company created while failing to disclose his or her close financial ties. Often, the moral dilemma is to agree with the company shelling out the money over sound, scientific inquiry and an unbiased view toward finding the most efficient and cheapest methods to cure patients.

Which makes the following piece from the press release particularly unnerving: “In no case did journal articles reveal how substantial the payments were to the authors. Almost all of articles were directly related to a device, like a hip implant, made by the company. This study focused on orthopedic surgeons but other studies suggest other medical specialists also fail to have their industry ties published.”