Zdeblick has been an MSD spokesperson and salesman for many years, (I don't remember him ever going through sales training) earning an estimated $20 million dollars in patent royalties.
The reporter, John Fauber, questioned why the readers of JSDT were never informed that Zdeblick, aka Zig Ziglar, was a consultant for the company. Unfortunately, this question should have been asked many years ago. Old news is, well, old news. Mr. Fauber, an industry outsider, must understand that most of us that actually read spine publications have been laughing at Tom for many years, while he has been laughing all the way to the bank.
Six years ago, TSB was sitting in the audience at a spine symposium in Florida when Tom got up to speak about cervical spine disorders. In an instance, a clinical presentation turned into a promo for Medtronic's then new cervical plate. If you closed your eyes you almost felt like it was Dan Aykroyd selling the The Super Bassomatic 76. If Saturday Night Live ever revives this skit, I know just the right guy to play that role. The pathetic side to this story is that most of us, including surgeons, started to snicker about the study let alone Tom's sales pitch. Surely some laughed with envy.
TSB has no problem with Zdeblick getting paid for products that he truly developed. What bothers TSB and others is that as editor-in-chief he is potentially using his clout in publishing studies that commercially benefit Medtronic and financially benefit himself. Would he publish an article that compares the clinical efficacy of a Medtronic plate to a competitors using the same criteria only to find out that both products produce the same results in ACDF's? To paraphrase one of our surgeon readers, "Iz it the Plate or the Playa?" Rarely, if ever, does the surgeon- author(s) ever criticize the product's efficacy or design, why would they, if the study is funded vis-a-vis a grant by the company itself? Isn't that why products are named in studies in order to promote a companies product? Yet, this article raises a bigger question. Is this an assault on the integrity of the medical profession? Today, spine surgeons complain that they do not earn as much money as they had in the past, yet, with the advent of sham consulting agreements, sham royalty agreements, and the proliferation and commoditization of the spine market TSB would argue that there are many more opportunities for greater earnings than ever before.
But what about the publisher? How entertaining is it when Robert Dekker, director of communications for Wolters Kluwer Health/Lippincott Williams & Wilkins is quoted as saying that "all manuscripts go through a rigorous review process using reviewers who have an objective viewpoint." Objectivity is in the eye of the beholder. Is there any surgeon at JSDT that would question the commercial aspect of the white paper? How many of these reviewers have their own consulting agreements? Obviously Dekker declined to provide a list of reviewers. The reader has to laugh at the level of transparency at WKH/LWW. TSB thought the whole purpose of a white paper was to provide the company clinical/commercial visibility? Dekker claims that coverage given to Medtronic products is in no way tied to their relationship with Zdeblick. As Scrooge once said, Bah humbug. Where does Mr. Dekker think his advertising revenue comes from?
If Senators Grassley and Kohler are really serious about enacting the Physicians Payment Sunshine Act of 2009 one of the guidelines should be that spine surgeons be required to wear the logo of the company that they represent on their lab coats in their office and have a promotional billboard in the waiting room for patients and sales people. Considering that surgeons have become personal spokespeople for companies, this really isn't a bad idea. Think of how much more efficient this would make the salespersons life. No more cold calls, no more free lunches, more focus and better time management. Maybe its time that patients have the right to choose the product that they would like the surgeon to implant considering it is their body? In the end, nothing has really changed, and like TSB said old news, is well, old news. You know what Sonny and Cher once sang, "And the beat goes on, And the beat goes on..........drums keep pounding the rhythym to my brain, la de da de de, la de da de da."