The U.S. Attorney's Office announced a plea bargain yesterday regarding a top Army doctor who accepted nearly $5,000 from a medical-device company. The feds say it was illegal for Jason Davis, at least until recently the chief of cardiology at Madigan Army Medical Center(pictured at right), to take money from a company trying to bribe him into using their products. Wait a minute: Isn't that standard procedure in the medical world?
It's a perfectly understandable rule. In this case (see pdf of plea agreement), for instance, Davis "almost exclusively" used the pacemakers and defibrillators made by Guidant Sales Corporation, the company that paid him the money, according to the U.S. Attorney's Office. Not only does that raise questions about whether Guidant's products really were best, but Jennings says one has to wonder whether the patients really needed a device at all (although the government is not making any claims concerning possible harm to patients).
Yet Jennings notes: "We're playing by a different set of rules."
It's not only legal but expected that private doctors will take gifts from medical-device and pharmaceutical companies, whether the goodies be money, fancy dinners, or hotel stays, as a Washington Post story related some years back.
The medical-device industry is especially ripe for conflict-of-interest opportunities, according to its own trade group, the Advanced Medical Technology Association. It's such a fast-growing field that it has attractive Fortune 500 companies and start-ups alike, all trying to cash in on billions of dollars in revenue and investment. These companies use doctors to develop their products, a recent article by a board member of the association observed, and the start-ups often pay M.D.s in stock options.
The article advises against stock-option payments, given the incentives it creates for doctors to concern themselves with the financial success of companies rather than the welfare of their patients. Yet, in a testimony to how entrenched is this system of mutual back-stroking, the report concludes that the solution is not to ban gift-giving but to "manage" it with "clear principles and fair-market values."
The article, incidentally, was written by Paul LaViolette, the former chief operating officer of Boston Scientific Corporation--which owns Guidant, the company that paid thousands to Madigan's chief cardiologist.
Davis, whose attorney Steven Krupa declined comment on his client's behalf, faces up to one year in prison and $100,000 in fines.