Reply to Letter from the Editor, Volume 9, Issue 1

HSS Journal: Volume 9 Issue 3

Richard Shindell, MD,
Phoenix, Arizona


I read with interest your letter from the editor in the HSS Journal Volume 9 Number 1, February 2013. I think while you have identified one of the major problems that we have in medicine, I think we need to speak more clearly and concisely about what the actual problem is. I have watched over the years as we have asked for better reiteration of disclosures that speakers and authors are required to make and I think we have not only accepted a lack of veracity (a study from a few years ago showed a significant disparity in disclosures simply between two similar meetings several months apart) as well as allowing people to hide behind letters which designate their level of involvement. These disclosures are all accepted in spite of the fact that we have known for years that the outcome of a study is directly related to the involvement of outside monetary influence. Again, as we watch papers being presented from the podium, I do not recall anyone ever acknowledging a conflict of interest and the slide that includes their industry involvement stays on the screen no more than two or three seconds and is usually waved off as not representing any conflict for that paper.

I think if one were to look at the overall reimbursement structure in medicine, one would suspect that physicians would be making less money each year and I do believe this is true for the most part in the private sector. I think, however, we need to just simply stand up and look at the number of physicians, predominantly I suppose at the top of the field and officers in our organizations, who are millionaires several times over by nature of their industry involvement.

Certainly, this never took place in years past and I believe our predecessors would have accepted that any advancement they made in medicine was simply public domain. I am certain that if you looked at your own faculty, there are several members receiving well above their salary range from involvement as industry consultants and speakers, much of which really does nothing to advance the field of medicine in a proportionate fashion.

Indeed, I can look to my own career and see where I have been led astray by advocates of my procedures, techniques, and instrumentation, none of whom seem very willing to apologize to patients or the field of medicine for their advocacy.

While my career has been somewhat more low key than those of the officers of the organizations to which I belong, I believe I can hold my head a bit higher in terms of ethics. I am proud of the fact that I have never turned a patient away for issues of money and that the industry representatives who call on me know that the easiest way to leave my office is to offer me something that violates ethical codes.

This article appears in HSS Journal: Volume 9 Issue 3.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.

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