October 13th, 2010
No Conflict, No Interest
Shanti Bansal, MD
On a brisk, cold evening I boarded an overnight plane from my hometown to Cincinnati. Once I landed, a gentleman dressed in a black suit with a grin over his face was waiting for me at the airport to drive me to my hotel. The driver led me through green untouched pastures and over a river and through bustling neighborhoods. I asked to be dropped off at the hotel prior to going to the classroom and the driver reluctantly accepted noting that I might be late for the lectures.
Some weeks prior, TheCompany Inc. (the names in this post have been modified) had offered me an educational course on atrial fibrillation which I agreed to attend. The driver dropped me off on TheCompany’s perfectly manicured grounds adjacent to a nondescript building. There, I entered a classroom designed specifically for educating physicians. Our first speaker was Ajay, who has made significant contributions to the field of atrial fibrillation. He reviewed slides on anatomy, physiology, and ablation strategies pertaining to atrial fibrillation. He spoke to a group of fellows and community electrophysiologists in the middle of the classroom as black suited representatives from TheCompany sat on either side.
The message was clear: atrial fibrillation is a problem and ablation is a necessary evil. When Ajay was lost for words, he made a quick furtive glance at the black suited representatives, who provided clarification. It was clear the slides he and the other speakers were presenting were written by TheCompany and the message was orchestrated carefully. After several hours of lectures, we filed into a laboratory filled with TheCompany’s devices and tools. We spent many hours working with TheCompany’s ablation catheters and software with Ajay and TheCompany’s representatives by our side. They were all eager to show us how to use their tools clinically.
After two days of listening to Ajay, other prominent electrophysiologists, and TheCompany representatives, I was ready to go back to my hometown. On my car ride back, I was reflective. I was asked to participate in an educational event that was designed in part to showcase TheCompany’s products and in part to educate physicians. What is the role of industry in educating physicians on the clinical use of their technology? As an academic physician, where do you draw the line between your message and one of industry’s? As a participant how do you separate marketing from medicine? Watching the rolling hills of Cincinnati go by from my car, I felt a little disenchanted but confess that I was eager to use what I had learned over the weekend.
2 Responses to “No Conflict, No Interest”
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Dr B,
Nice post. I too, have been in that classroom, perhaps when you were in elementary school.
Not all that is industry-sponsored is bad. In fact, that company you speak of has done much for the world of catheter ablation. And in doing so has benefited both patients and themselves. To me this seems just, ideal even.
JMM
I am not surprised by the confusions & comments of both Physician practiting in so-called 1st world country(?). Accutally as Physycian of 3rd world country(!) I can feel why physician through-out the world are very eger to have an education from Multi-national Pharma to be loaded with cutting edge research informations(?). And become filled with grandiose sense of joy that they know something that is worth knowing!
Physician-Industry relation is a nice relation indeed(?). A relation that will lead to Practicing physicians to prescribe expensive drugs,use cutting-edge technology to open the blocked coronary or carotid arteries & encourage physician-researchers to publish positive results of some intervention in a highly reputed(!?) peer-reviewed journals,so that it can get immediate approval by drug approval agency of their country etc & etc!!
It is a never ending legacy & an eternal bond which constitutes a realization of both side as well as actualization! At the end of the day we all receive monetary gain,fame for a senior post.Both parties are happy!
But with which cost? A cost,unfortunately,cannot always be measured by money I afraid! A cost of ethical/moral degradation.A cost has long been tauted as 10/90 gap.A perception that all suffering of humanity have a technological fix!!It is fear that hunted some section of USA as “Socialized Medicine” when president of USA Barak Obama proposed his new policy for health in his country. How unfortunate that man is! Peoples of mightiest country in the world(?) came out with placard showing we don’t want “Socialized Medicine”!!
At the end as a poor Physician from a poorest country,3rd world I afraid,I feel that Physician as a community throuhg-out the world need know some thing about social justice. A recent publication by WHO,named Closing The Gap,showed what social injustice can do,can make a deferent between life & death.Industry may not be happy to know that implementation of social justice in a given country can achieve a feat! A changes in global statistics on mortality & morbidity that their(Industries)all accumulated cutting-edge technology might fail to achieve!! It’s a cautionary note!Any one can free to think that a poor chap from a poorest world dare to give us advice!
Yes it is an advice!It is an advice to 1st world Physicians & Industries alike that what 3rd world can achieve in health & well-being by implementing a low-tech concept like “Social Justice” may become a matter of jelousy for 1st world.
It is not an anti-science advice,I afraid, somebody may infer from my above comments.It is an appeal, how Science can be more efficiently integrated to the concept of ethics,morality & lastly with social justice.