Journal editor linked to spinal implant royalties
Filed under: Conflicts of interest, Hot Health Headline
John Fauber of the Milwaukee Journal Sentinel continues his coverage of conflicts of interest in medical research and journals with a look at journal editors. First, Fauber lays out the case in question:
- For seven years, a University of Wisconsin orthopedic surgeon (university bio | hospital bio) has been editor-in-chief of the Journal of Spinal Disorders & Techniques.
- During that time, he’s received more than $20 million in patent royalties thanks to spinal implants sold by Medtronic.
- Also during that time, an average of more than one Medtronic-related article appeared in each issue of the journal, most of them positive. Some were even co-authored by the editor/surgeon himself and related to the implant for which he gets royalties.
- Despite these coincidences, the journal never disclosed the potential conflict of interest.
Fauber then goes on to explore why journal editors aren’t mentioned more often in conflict-of-interest scandals, and then to explain exactly why those editors hold the sort of power that makes these conflicts particularly distressing. As Fauber explains, editors of medical journals can accept or reject manuscripts of studies involving drugs or devices - something that can make or break the product.
They can send a study out to peer reviewers who may be sympathetic to a particular drug or device by virtue of their own financial relationships with the companies that make those products. They can give authors more leeway to say positive things about a drug. They can turn down studies that say bad things about the product of a company they get money from.
The author of “On The Take: How Medicine’s Complicity with Big Business Can Endanger Your Health
Earlier coverage:
- Wis. researchers didn’t disclose conflicts to journals
- U. of Wisconsin conflict of interest policy gutted
- Wyeth paid university for ghostwritten articles
- University’s ties to testosterone therapy questioned
- Drug companies aim to sway docs through classes
- Wyeth-funded course promoted hormone therapy
- Academic docs collect money from manufacturers
One town’s end-of-life talks lead to living wills
Filed under: Health care reform, Hospitals, Hot Health Headline
NPR’s Joseph Shapiro has unearthed an outlier in the nation’s health care cost numbers, one which demonstrates the reality of regular end-of-life-care discussions that extremists once branded “death panels.”
In La Crosse, Wis., 96 percent of adults die with a living will, a rate far higher than anywhere else in the country. It seems to be no coincidence, then, that at the city’s Gundersen Lutheran hospital, Shapiro writes, “less is spent on patients in the last two years of life than any other place in the country.”
Right now, Gunderson officials say, it’s expensive to take the time to spend the time necessary to educate patients on their end-of-life options, and Medicare doesn’t reimburse the hospital for such activities. Driven by ethical considerations, the hospital spends millions on the program anyway. There’s a provision in the reform package passed by the House of Representatives to pay for these activities, and La Crosse hospital officials are pushing for its success.
“When people see the low cost in La Crosse, there are assumptions about rationing care, about denying care, about limiting — that we limit care for our patients,” says Hammes. But it’s not that dying people in La Crosse are denied care, he says. It’s that they’ve thought out their wishes in advance, so they get exactly the care they want. And often that means avoiding excessive and unwanted care.
Shapiro closes his piece with an elegant summation of the lessons the rest of America can learn from La Crosse:
(That’s) why doctors and patients keep talking about end-of-life care in La Crosse: because choices are complicated. Because people’s feelings change about the treatment they want. And the best way to handle that is to know all your options, well in advance of a health care crisis.
Related
Steve Kroft of 60 Minutes reports on end-of-life care, finding that “many Americans spend their last days in an intensive care unit, subjected to uncomfortable machines or surgeries to prolong their lives at enormous cost.”
He talks to experts about the process of dying and why so many people end up “dying badly,” that is, suffering and connected to machines in hospitals, despite the fact that most people say they want to die at home.
Wis. researchers didn’t disclose conflicts to journals
Filed under: Conflicts of interest, Hot Health Headline
Milwaukee Journal Sentinel reporter John Fauber reports that conflicts of interest that local researchers disclosed to the university were not always disclosed when those researchers’ work was published.
Their investigation, a “spot check” of about 40 researchers, uncovered at least nine conflicts, such as the cancer specialist (bio) at the University of Wisconsin who “co-authored a medical article on TomoTherapy, a radiation therapy system developed by researchers at the university.” The article failed to mention that the physician had disclosed the university that he’d make $20,000 in 2008 consulting for TomoTherapy, and that he owned TomoTherapy stock options.
Fauber explores the causes of these failures to disclose conflicts of interest, which include systemic weaknesses in both research and publication and reliance on an “honor system.” He talks a little about his reporting method; it’s the sort of story that can be localized by anyone whose local university has a conflict of interest disclosure policy.
Madison media team up, focus on health access
Filed under: Health journalism, Hot Health Headline
Instead of bickering and battling for scraps when times got tough, media in Madison, Wis., set aside differences, circled the wagons and worked together to produce top-shelf journalism.
The resulting collaboration, titled All Together Now, involved two dozen local outlets and focused on in-depth reporting on local access to health care. The related stories are rolling out now, and they cover hefty topics such as state insurance oversight, insurance reform in the University of Wisconsin system and a number of editorials and explorations of the clinics that are delivering much of Madison’s health care these days.
U. of Wisconsin conflict of interest policy gutted
Filed under: Conflicts of interest, Health data, Hot Health Headline
The Milwaukee Journal-Sentinel’s John Fauber reports that the University of Wisconsin’s proposed conflict-of-interest rules have been heavily watered down with the addition of an exception for doctors, including orthopedic surgeons, who implant devices. This is also a group of doctors who tend to bring in significant amounts of money for the university and thus tend to be rather influential.
Fauber:
After getting pressure from orthopedic surgeons, medical school and UW Medical Foundation officials amended the policy to allow doctors to make presentations for medical-device companies, provided they are paid no more than $500 an hour plus food, transportation and lodging.
In recent years, some of the most egregious ethical violations in the medical field, including allegations of kickbacks and extravagant payments, have involved orthopedic surgeons and companies that make implantable devices.
Advocacy group releases mental health media guide
The second edition of a media guide for reporting on suicide and mental illness, prepared by Wisconsin United for Mental Health, is now available. The guide, “Open Minds Open Doors: A guide for Media,” provides statistics, facts and background data as well as suggested terminology and guidelines for avoiding the stigma of suicide and mental illness. The guide recently won a Mental Health America 2009 Media Award in the advocacy category.
According to Wisconsin United for Mental Health’s Web site, its mission is to “educate and increase awareness about mental illnesses, to eliminate stigma and discrimination, and promote recovery.”
Barriers in 5 Midwest states chill public access
A study from the the Citizen Advocacy Center finds that open government laws in Michigan, Ohio, Illinois, Wisconsin and Minnesota have systemic barriers that chill public participation and access to government.
The Center analyzed each state’s Freedom of Information and Open Meetings Acts and found striking similarities between all states, including:
- Open government laws are sporadically enforced, which means public bodies are more likely to be unresponsive to records requests and employ exemptions to keep meetings closed.
- No state surveyed has a government office with statutory authority specifically created to oversee and enforce sunshine laws.
- State employees are not adequately trained to carry out open government policies and may be unintentionally violating the laws.
- Citizens may be able to attend meetings, but there are very few opportunities to participate.
The Midwest Open Goverment Project is a comprehensive study of the Freedom of Information and Open Meetings Acts in those five states, under the auspices of the Citizen Advocacy Center.
-
Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
