Study finds widespread conflicts of interest for cardiologists

Heart diseases are the leading cause of death in the United States and account for a large proportion of acute medical care provided by doctors across the country. But a recent study raises concerns that the majority of the doctors writing practice guidelines for cardiology practice are being paid one way or another by the medical device and drug manufacturers. Many doctors also own stock or give speeches on these companies' behalf.

The widespread financial ties between doctors and medical manufacturers not only raises concerns about doctor's objectivity and the level of care they provide but also raises concerns for those who may have been the victims of medical malpractice. The practice guidelines and other journal articles or studies published by these doctors on behalf of the manufacturers are often used in medical malpractice trials to define what constitutes the proper standard of care.

The practice guidelines issued by groups including American Heart Association and the American College of Cardiology. These guidelines provide instruction on when certain procedures or devices are recommended.

For example one cardiological guideline states that defibrillators are 'indicated' for patients suffering a decrease in pumping ability because of a prior heart attack, and that the device 'may be considered' when the decreased pumping capacity is from another cause, but that heart defibrillators are 'not indicated' for patients that are not likely to survive. Of the 34 doctors who constituted a 2008 panel to develop defibrillator guidelines, 27 had some financial ties to medical product or pharmaceutical company.

While these companies say that the fast pace of medical technology and complexity of their products requires that they work closely with doctors to educate the medical community, it is hard to ignore potentially dangerous impact from these potential conflicts of interest. The problem does not necessarily arise in the case of one doctor making one questionable decision but the net effect of having the majority of doctors who determine what constitutes good health care being financially reliant on medical companies.

Source: The Wall Street Journal "Study Cites Cardiology Conflicts" Thomas Burton, March 28, 2011

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