Where in the World is Dr. B?Posted On: November 24, 2014
I enjoyed participating in the editorial published in the Grand Rapids Press outlining the Sunshine Act. In addition to this piece, I am completing an editorial for our national plastic surgery journals.
I believe transparency concerning all physician compensation by industry is very important. It can expose potential conflicts of interest for physicians that may unduly influence the use of a drug or product.
Where the Sunshine Act falls short is, it implies that the physicians benefit fully from the amounts listed. Listing the amounts paid to doctors without any clarification or categorizing the reason for the payment.
Year to year, the money I receive from industry leaders, currently Allergan Medical and LifeCell can be divided into 3 main categories:
- Research & Education
- Patents and Medical Device Sales
- True Consulting
All money received for research is a pass through. Our practice is paid to administrate the studies to see if current FDA-Approved devices have any new applications to benefit patients. It actually costs our practice to perform clinical research or is a wash financially.
I currently have 8 medical patents that has generated 5 new medical devices that are in various phases of development. We have licensed some medical devices to companies and have received compensation for them.
The actually consulting dollars I have received represents about 1/3 of my over-all compensation reported as mandate and is not allowed to be specified by the government. Approximately, 1/3 of that amount is for travel and expenses related to speaking or skills labs. I love teaching and travel on average once a month to teach other plastic surgeons on new implants or devices and how and when I have found them beneficial in my patients. I focus on any complications I have had or on specific techniques and let the surgeons decide if they have a place in their own practices. What most people don’t know is that this compensation I received does not cover my time out of my practice and it is actually a detriment financially for me travel and teach.
My hope is that in the future when the government decides to look outside of their own ranks and publish this data that they list the actual accurate information and categorize the actual basis for the payment.
Being involved with national education of surgeons, I believe it is easy to see any bias from the podium or in our journals. For patients, it is more difficult and easier to hide. I believe it is a good idea for patients to ask their surgeons or doctors on alternatives to the devices or medicines they are taking. I have been asked by patients to use an implant from another company and if equivalent I am happy to do so. It is very important for all physicians to stay focused on their patients…always on their patients!
Companies want to work with doctors who have the most experience with a product or procedure. No medical device of any significance has ever been developed unless corporations and doctors work together to solve a problem or improve patient outcomes. I would argue the surgeon you want to see and perform your procedure is the one who has the most experience, is teaching his colleagues on new products and techniques
The most important thing to me along with my faith is my personal integrity. I do not compromise the care of my patients for any monetary compensation. I do the best I can using the device I believe will obtain the best outcome regardless of the company providing the product to achieve the best result I can, every time.