In the News

Orthopedists’ Financial Conflicts Can Hurt Patients, Surgeon Says

by Cheryl Clark
March 22, 2015
HealthLeaders Media

It’s financially compelling for doctors to do things that don’t help patients.

Financial conflicts of interest often drive physicians to perform worthless surgeries, but the field of orthopedics “is one of the worst offenders,” says an Indiana orthopedist who has launched a “moral persuasion” campaign to convince his colleagues to stop.

“It’s really hard for doctors to acknowledge this and change their ways,” says James Rickert, MD, who years ago founded the Society for Patient Centered Orthopedic Surgeryto address the problem.

It’s especially tough for doctors who own related businesses that depend on surgical volume, which puts even more pressure on them to “be more like businessmen instead of doctors,” he says.

A lot of orthopedic surgeons “own part of the distributorships that sell the total hip or knee implants to the hospital, and they’ll make a ton of money on that. Or they own the imaging center they send their patients to. They own a piece of the surgical center. They know if they’re not doing a lot of surgery, they may lose money on their overhead,” Rickert says.

A series of four reports from the Government Accountability Office documents greater numbers of procedures referred by physicians who own providing businesses, compared to referrals from non-owners.

“That makes it really compelling for doctors to do things that aren’t really going to help their patients. They become more like salesmen, saying things like, ‘Well, it might help.’ Or, ‘We don’t have much to lose, let’s try it,’ knowing full well the data shows there’s very little chance the procedure will help and some evidence the patient could be hurt.”


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