Senate hearing questions doctors' ties to medical device makers

The industry has made improper payments to physicians in an attempt to influence their medical judgment, senators said.

By Dave Hansen, AMNews staff. March 17, 2008.

Washington -- Physician relationships with medical device makers came under fire at a Senate Special Committee on Aging hearing last month. So far, legislation is focused on manufacturers' conduct, but lawmakers and enforcement agencies expressed concern about doctors' potential conflicts of interest as well.

The Feb. 27 hearing was a continuation of a broader examination of physician dealings that Committee Chair Sen. Herb Kohl (D, Wis.) launched last year with a look at doctors' relationships with pharmaceutical companies. He sponsors a bill that would require large pharmaceutical, medical device and biologic companies to disclose gifts to physicians exceeding $25.

The American Medical Association is trying to modify some language in the bill, called the Physician Payments Sunshine Act. AMA ethical guidelines prohibit doctors from accepting gifts of substantial value, or with conditions attached, from medical device companies.

At the hearing, the Health and Human Services' Office of Inspector General offered several examples of conflicts of interest between the medical device industry and physicians. For example, between 2002 and 2006, the top four manufacturers of artificial hips and knees paid physicians more than $800 million in 6,500 consulting agreements, said Gregory E. Demske, OIG assistant inspector general for legal affairs.

While some of these payments were for legitimate services, the federal government found evidence of kickbacks disguised as consulting contracts, royalty agreements or gifts designed to influence the physicians' medical decisions, Demske said. In September 2007, the four companies entered into a settlement with the federal government for $311 million to resolve allegations that some payments were improper.