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Transvaginal Mesh Trial Update: The Treating Physician as a Consultant – Conflicts of Interests

January 1, 1970 · FLEMING | NOLEN | JEZ, L.L.P.

When we develop an ailment or symptom that warrants medical attention, we typically seek the help of a health care provider. In doing so, we may look for assistance in finding a doctor to diagnose and treat our medical issues. Modern technology makes available to us a variety of information to consider when choosing the correct physician.

Some of the more common factors considered are the doctor’s education, experience, hospital affiliations, insurance program affiliation and of course, patient reviews. Very rarely does the patient investigate whether the physician is connected in some way to the big pharmaceutical or medical device industry. How does that affect my health care? Is it important enough that I should care? You decide.

The information can range from the doctor’s education, experience, and patient reviews to hospital affiliations and insurance he or she accepts. At no time during this process do we ask ourselves, if the physician is connected in some way to the pharmaceutical or medical device industry? Maybe we should.

Physicians are courted by pharmaceutical and medical device manufacturers to become what are called key opinion leaders or consultants. They are expected to do a variety of tasks and are paid consulting fees. Some of the tasks include:

  • Ghost writing articles – This is where the pharmaceutical company or medical device manufacturer writes an article and then pays a physician to promote the article as author.
  • Teaching other physician’s about the product
  • Speaking at conferences and promoting the product
  • Participating in research related to the product

The consulting fees can range from $1000.00 to over $500,000. In fact, some physician consultants have been paid millions of dollars. With this type of system, one can only wonder if it creates a conflict of interest between the physician and his or her patients. As patients, are we entitled to be made aware of the relationships between our treater and a big pharmaceutical or medical device company? Is it a factor we need to consider when we are deciding upon a physician? Is there potential for physician bias in these situations?

In the on-going transvaginal mesh trial, Dr. James Raders, the plaintiff’s urogynocologist, testified that he was an Ethicon, a Johnson & Johnson company, consultant since 2005. And during that time, Ehticon paid him over $400,000. One can only wonder if the plaintiff knew this when she visited Dr. Raders. In any event, it does raise a question of conflict of interest between the physician, the patient and the manufacturer.