TSB wanted to write an open letter to your organization commending it for the wonderful job that you continue to do as a medical society. Your organization is dedicated to promulgating the professions highest standard of evidence based and quality spine care. Unfortunately, the past few weeks have cast an image on your profession that leaves many believing that the foxes are guarding the hen house. Those of you that are members of NASS' executive committee must feel slightly embarrassed by last week's and this week's Wall Street Journal expose on Dr. Makker. Maintaining and preserving your professions integrity with America's public must be your top priority. It must be concerning to each of you that the actions of a few, is casting a black eye on the many spine surgeons that really do care. Words like honor and trust in your disclosure policy have no meaning if one does not live up to those standards.
The general public doesn't truly understand the importance of having collaboration with physicians in developing new modalities of treatment, assessing the potential of an idea, or simply providing their clinical expertise, all which result in enhancing the patient's quality of life. This synergy is vital for our mutual existence. What is concerning is that there a fundamental breakdown between doctor and patient when the patient is viewed as a profit center. And it should be a concern. Recently, TSB reviewed the program for the 2011 AANS meeting, granted another organization whose many members perform spine surgery. There were over twelve pages dedicated to disclosure along with five pages of surgeons that are not affiliated with any company. Many of those surgeons were from foreign countries. If a spine surgeon is working with five or eight companies on projects, how could this individual really focus on the task at hand? Undoubtably, we live in America and no one has the right to tell another person how he or she can pursue one's livelihood, yet, when outside financial interests and bias influence a surgeons decision making process, this behavior is damaging not only to the profession, but also to the patient.
With all the negative press that the Wall Street Journal and New York Times have published regarding the Dr. Makker's, Kuklo's, Polly's and Wang's, just to name a few, is there no concern that only one surgeon had the nerve to stand up, identify himself, and be heard in a public forum? What does this say about our industry and your profession? Contrary to what NASS believes, there are many surgeons that still fail to disclose the many side deals that they have initiated for their own financial gains. If disclosure is important to your organization then you need to expand the scope of the types of financial relationships that your members partake in. Unfortunately, past members of NASS have set a poor example of how to conduct oneself both professionally and financially by creating an atmosphere of gaming the system, and for those tenured in this business, we know who they are. How many of your members are investors in companies and have failed to disclose? How many are actively involved in POD's that have failed to disclose? How many are owners of Physician Owned Hospitals, and have failed to disclose?
The bylaws that you espouse can be interpreted as nothing more than lame duck principles in a futile attempt to create an image that you are a governing body for an organization that has no legal authority to police or monitor its own members. Hopefully, this will be a wake up call.