This article from the Wall Street Journal is important in a number of ways: Implant surgery is both highly expensive as well as hotly debated as to efficacy and indications. The article suggests that not only are the surgeons profiled therein highly compensated for their expertise in the operating room (and are not compensated nearly as well for declining to perform a procedure), but they appear to be receiving incentives from the device manufacturer for their relationship – one that is more than likely contingent upon continued use of and promotion of the devices.

The article discloses relationships of the sort that in the past were unreported but significant. Spine surgery is often suggested in workers’ compensation cases as well as auto accidents. The indications and cost of such procedures is highly relevant to those overseeing such claims.

Beyond continued scrutiny and perhaps regulation, what other suggestions are in order? One is that any patient should ask and have the right to know if their prospective surgeon is receiving compensation of any sort from device and pharmaceutical manufacturers, including the amount and the rationale behind the royalties. If surgery is proposed and a device by a company compensating the physician is to be used, it would be reasonable to get a second opinion from a physician who has no such interests.