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Working with medical companies whose products they are supposed to be testing can make a doctor a millionaire, according to reports surfacing in the United States this summer.
The latest revelations come from Minnesota, where documents released by the offices of Iowa Senator Charles Grassley show that University of Minnesota researcher Dr. David Polly billed Medtronic for reviewing one of its products at the request of a local non-profit group.
Back in 2005, Dr. David Polly participated in a review of a new technology in spine surgery by an influential nonprofit group. After he concluded the work, the University of Minnesota expert submitted a bill for some of his time to Fridley-based Medtronic.
Four years later, leaders of the nonprofit group — the Bloomington-based Institute for Clinical Systems, or ICSI — say they wouldn't have let Polly participate in the review had they known about the billing arrangement. Technology reviews by ICSI are supposed to be impartial, they say, and a Medtronic device was among those being evaluated.
"I was shocked," said John Sakowski, the chief operating officer at ICSI, who learned of Polly's bill with the recent release of Polly's records by Sen. Charles Grassley, R-Iowa.
Although surprised, Sakowski said ICSI is not accusing Polly of wrongdoing in the matter. The nonprofit group didn't specifically ask whether the surgeon was billing an interested party for working on the review, and ICSI said the results generated by the group were solid — even with the apparent conflict of interest.
Medical ethicists say they have questions about how both ICSI and Polly acted during the episode, but they conclude that the moral of the story goes to a much broader point: Disclosure requirements throughout the health care industry have been woefully lacking.
"More independent control of financial relations is needed, clear conflict-of-interest rules are needed, and investigators have to receive proper education about conflicts of interest," said Trudo Lemmens, a medical ethicist at the University of Toronto. ...
Polly's bill for working on the ICSI review was just one of several hundred items in billing records released last month by Grassley. The senator has been probing the financial ties between doctors and medical companies for several years and has introduced federal legislation that would require more public disclosure.
The records released last month showed how Polly accumulated nearly $1.2 million in consulting bills to Medtronic between 2003 and 2007. Compared with the grand total, the bill for work at ICSI was a drop in the bucket.
It's not the first time Grassley's office has revealed payments to doctors and researchers. Last June, a Wisconsin newspaper used documents from his office to detail millions in payments to 11 doctors with the University of Wisconsin School of Medicine and Public Health.
Topping the list of those receiving large sums from medical companies was a group of UW orthopedic surgeons. They include:
Paul Anderson, a professor of orthopedic surgery, who got $150,000 for eight days of work as a consultant from medical device-maker Medtronic. Anderson, who could not be reached for comment, also earned a UW salary of $755,000 in 2007.
Ben Graf, an associate professor of orthopedic surgery, who got $770,000 in royalties from device company Smith & Nephew. Graf, who could not be reached for comment, also earned a UW salary of $591,000 in 2007.
Clifford Tribus, an associate professor orthopedic surgery, who got $310,000 for 15 days of work as a speaker and consultant and from royalties from device company Stryker Spine. Tribus also earned a UW salary of $618,000 in 2007.
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