Physician Heal Thyself (II)

Here’s a troubling lead paragraph from yesterday’s Wall St. Journal:

Some doctors helping evaluate the effectiveness of an increasingly popular device for clearing clogged arteries own stock and options in the company that makes it, regulatory filings show.

The company is creating a registry to demonstrate the device’s effectiveness rather than conducting a clinical trial with a control group. The fact that physicians are being compensated with stock options for contributing to the registry makes the data highly suspect and may put patients at risk.

Dr. R. Stefan Kiesz, head of the San Antonio Endovascular & Heart Institute and a contributor the registry, says:

The fact that I own shares doesn’t influence me. We do have a large population of patients who have done better than I thought” with the SilverHawk.

I don’t believe that for a second. Do you really think he would talk about SilverHawk the same way if he owned shares in a competitor instead?

See Doctors Take Stock, Supply Data for the full story.

August 16, 2005

8 thoughts on “Physician Heal Thyself (II)”

  1. .
    Excellent post! I wonder how many physicians are actually involved in this, and will the AMA get out in front of it with full-disclosure guidelines?

    A quick search of the AMA site yields no mention of this issue.

  2. Jerome Kassirer has an interesing post on this subject up at oupblog:
    “Professional societies should also announce new guidelines to prohibit even more common practices such as membership on industry’s speaker’s bureaus, paid collaborations with industry to develop educational materials, and paid consultations with industry on marketing issues.”

  3. .
    Hmmm….I was just over there (I check there every few days), and saw his post. So I pasted links to your posts in his comments section (I had them on my blog), and headed over here to tip you to Dr K’s article.

    It’s a small (blog) world! 😉

  4. Well, if you people could just see the results my uncle had. Dr. Kiesz saved my loved ones leg from multiple non-healing wounds. If you know nothing about the device then do the smart thing and Shut Up!

  5. Dr. Kiesz is a great doctor with sound ethics. I don’t know about this device but because of the miracles he performed on my Mom to save her heart, legs and kidneys you can take it to the bank if he says this procedure works.

  6. I think there is one important part of the equation being missed in this discussion:

    Dr. Kiesz is a world leader in interventional techniques. I believe the SilverHawk was (and perhaps still is) the only — and certainly the best — plaque-excision method to revascularize below-the-knee arterial blockages. There wasn’t any truly competitive system, I would guess, in the mind of Dr. Kiesz, who is very likely one of the top five interventionalists in the world.

    I’ve had direct dealings with Dr. Kiesz, and i’m aware of his many contiributions to the advancement of his field, including new procedures, new devices and many studies. This is an evidence-based guy, to be sure.

    If there was another system that was better, that would be the one for which he was a spokesperson, and those would be the shares he owns.

  7. I’m the same anonymous who posted the immediately preceeding comment. Had something to add after I checked my information…

    Dr. Kiesz was indeed the first person in the world to perform below-the-knee plaque excision. And SilverHawk was the first and only such system. If there is another system in existence today, it isn’t as well-known, popularly used or successful (in terms of empirical medical outcomes, not business revenues!). The idea that Dr. Kiesz has bad ethics ignores these facts.

    Here’s your main argument:
    “Do you really think he would talk about SilverHawk the same way if he owned shares in a competitor instead?”

    Please enlighten us. Who are the competitors? And do the clinical results show that they are TRULY competing?

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