News: Surgeon–Industry Relationships: Where To Draw the Lines?

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Surgeon–Industry Relationships: Where To Draw the Lines?

by Gabriel Miller

National Harbor, Md.—When versions of the Sunshine Act were originally passed in states like Massachusetts and Vermont in 2008 and 2009, there were running jokes in the exhibition halls of surgical society meetings around the country. The fact that surgeons from these states were barred from drinking the free cans of Diet Coke that device companies might hand out at their booth seemed ludicrous.

One surgeon at a meeting recently joked that “it’s been a long, lonely week avoiding all the pharmaceutical and device company dinners ... I could live this way for five or six days, but I don’t think I could live this way forever.”

The jokes, however, stand to become more than a laughing matter. In 2009, Congress introduced a bill that would require physicians to disclose any gift worth more than $100, that later was rolled into the health care reform law enacted in March 2010. The Physician Payment Sunshine Act provisions included in the Patient Protection and Affordable Care Act lowered the gift threshold to $10 and provided for the creation of a national, publicly accessible database that would list physicians’ names, addresses and the nature and value of all gifts received from industry.

The database may be the most visible measure that affects physicians, but for surgeons in particular, it’s probably not the most far-reaching. Conflict of interest among medical professionals has become a national debate in medical colleges, in Congress and across the front pages of national newspapers. Many surgeons agree that bias is present, but they argue that medical devices are vastly different from pharmaceutical products.

At the 12th World Congress of Endoscopic Surgery last year, experts voiced concerns rippling through the surgical community that losing or denying industry support might hurt graduate and continuing medical education (CME), the leadership of specialty surgical societies and the development of minimally invasive surgery as a whole.