Do you want to be a Doctor or a Consultant?

The conversation goes something like this. "Mom and Dad, I have decided that I want to go to medical school and become a doctor." The parents replied; "Why do you want to go into medicine?" "Because I love helping people, and believe that this would be an honorable profession." The parents replied;" but with the state of healthcare in the US (some type of government sponsored healthcare program), are you willing to work in a system that could potentially limit your earning capacity? The child states: "don't worry, not only will I practice medicine, I intend on becoming a consultant for some company in my chosen specialty, and make millions of dollars while I attempt to become the best doctor that I can be." With that the parents gave their blessing.

Somehow, somewhere, something has gone afoul in our industry. As the NY Times reported early this morning (7/15) more information is coming to light regarding the Kuklo/Medtronic affair. (It's starting to sound like the old movie The Thomas Crown Affair). He was a young, talented, and successful millionaire who tried to pull off the perfect crime (that's the story line for those of my younger readers). The question that must be asked is; " How does someone so smart and intelligent get himself caught up in a scenario that could turn out to be, as they like to call it in the US Army, FUBAR? Maybe we are starting to understand why the DOJ is shining a light on our industry, and it's not a flash light.

Accusations of falsified data, Medtronic stating that they had no knowledge of the study at Walter Reed (wink! wink! obviously someone had to know something) and bouts of amnesia during the disclosure process does not bode well for Dr. Kuklo. And now, it seems that both parties are attempting to perform damage control by distancing themselves. At least Dr. Kuklo gets to use his legal education in how he manages himself as this investigation moves forward (that law degree does come in handy). The question that is being asked by many is, "why would someone so intelligent forget to disclose that he had any financial tie to the evil empire." Why would he forge other surgeons names to a study?

In light of the Kuklo article, the question that needs to be asked is, why does every spine surgeon have a calling to be a consultant? Does it start during residency, when they are catered to by every company in the industry? Do they really believe that they have something to contribute? Not every idea is worth its weight in gold! Granted, there are surgeons that are truly innovators and inventors, but what percentage? 5%? 15%? 50%? 80%? It seems like every surgeon that you meet nowadays has a new idea and is looking for a consulting or royalty agreement? (Yes, there are those that deserve to be compensated) Do surgeons believe that one's ability to choose the right product for their patient is not skewed by a consulting agreement or an investment into a start-up or early stage company? Does a surgeon's relationship with a company affect a hospitals ability to negotiate a fair and equitable price if the surgeon demands access to that company's products? Could it be that consulting agreements became in vogue so that legacy companies could protect their marketshare or start-ups could be sold for a greater multiple than what they were really worth? The SpineBlogger's platform is not some "wishy-washy" website that aligns itself with surgeons and industry related companies to generate revenue. Those websites tell you the reader that everything is wonderful, and if you pay for your subscription you have an opportunity to be heard.

The real reason that this insanity exists is because there are a percentage of surgeons that no longer want to be surgeons, they want to be entrepreneurs, angel investors, venture capitalist, and portfolio managers. They want a piece of the action! It's like a drug. As Gordon Gecko once said, "Greed is Good!" They are no longer just doctors, they are now master marketeers, selling themselves to the highest bidder regardless whether they believe in the technology or not. But the blame cannot solely be placed on the surgeon. The real reason is that the industry perpetuates and condones this type of behavior. How many of you have been overheard expressing your disdain or disgust about our industry?

The SpineBlogger knows that between the whistleblower suit against Blackstone, aka The Three Amigos, and the Kuklo Affair it is inevitable that some surgeons and corporate managers will be wearing orange jumpsuits. Until then, its business as usual!