By J. Abbott Byrd III, MD
Ethics Committee Chair
"Hey doc, I'm Joe Spinerep with the Acme Spine Company. We are a new, small, private company but have some of the best spine widgets around. I have been trying to meet with you for a long time as you are one of the best and busiest spine surgeons in town. We have a great program for doctors like you and I wanted to make sure that you got in on the ground floor. Acme Spine is able to offer a stock option program to a small group of busy surgeons and while the company is privately held now, the plan is to go public when sales increase at which time those options will be quite valuable." ETHICAL???
"Well doc, if you are not interested in stock options, we have another program that might be attractive. Acme Spine is also putting together a small group of consulting surgeons to evaluate our full line of widgets. The program really won't take much of your time as all you need to do is fill out a product evaluation form after you do a case. We can only pay market rates for the evaluations but a busy surgeon such as yourself will have the opportunity to do multiple evaluations on our many products." ETHICAL???
"Well doc, if you are not interested in a consulting arrangement, we have another program that could help your practice. Acme Spine has a marketing package to promote you and our fine line of spinal widgets. We have tried it in other markets and it has worked great. Basically, we run newspaper and radio ads promoting our widgets and at the end mention that you are one of the few doctors to bring this great technology to the area. I am sure that this will increase your surgical volume." ETHICAL???
"Well doc, we don't seem to be making much headway but I would sure like to discuss this more with you over dinner. Why don't you let me take you and your wife out to that fancy steak restaurant in town. It is supposed to be one of the best around and has the best wine list in the state." ETHICAL???
"Well gee doc, I just don't know what else I can do to earn your business. It is a shame that we can't work together because I thought you and Acme Spine had a great future together."
The Ethics Committee is preparing a comprehensive document to offer ethical guidance for these and other questions with which the SRS, as an organization, and its members, as individual surgeons, are often faced. The document will begin with the SRS Conceptual Mission Statement which will broadly outline standards for ethical and professional practice and academic activity. The Standards of Professionalism (SOPs) section will focus on issues of importance to the individual surgeon such as advertising, conflicts of interest with industry, as well as expert opinion and testimony. Ethical issues of interest to the SRS will be addressed by the section on Professional Medical Associations (PMAs). This section will address the ethical relationship of the SRS with industry. Other subjects that will be addressed include society meetings, research support and the issue of conflict of interest for the SRS leadership. The document will conclude with the SRS Ethical Discipline Management Process which will clearly outline the reporting mechanism, evaluation and adjudication process for alleged ethical breeches.
It is the goal of the Ethics Committee to present the completed document to the Presidential Line for comment by late May and then to the Board of Directors for approval at the July meeting. After approval, the document will be presented to the membership at the Annual Meeting in Louisville.
Despite the many problems that surround our chosen profession, we must remember that it is the ethical practice of medicine that best serves our patients and sets our profession apart from many others.