physician-owned entities that derive revenue from selling, or arranging for the sale of, implantable medical devices ordered by their physician-owners for use in procedures the physician-owners perform on their own patients at hospitals or ambulatory surgical centers.
Unsurprisingly, this arrangement creates incentives for surgeons to recommend surgery at a higher rate, with the knowledge that they will get additional income from the use of implantable medical devices supplied by their POD.
The report contains the following findings regarding spinal surgeries:
- “POD surgeons saw significantly more patients (24%) than non-POD surgeons.
- In absolute numbers, POD surgeons performed fusion surgery on nearly twice as many patients (91% more) as non-POD surgeons.
- As a percentage of patients seen, POD surgeons performed surgery at a much higher rate (44%) higher than non-POD surgeons.
- In absolute numbers, POD-surgeons performed nearly twice as many fusion surgeries (94% more) as non-POD surgeons.”
I suspect the third finding above is the most important, as the other findings may be related to increased surgical skill, and therefore increased patient numbers, rather than increased incentive to perform surgery.
The report notes the conflict of interest caused by PODs. They therefore “compromise patient safety as patients receive high-risk treatment beyond what is medically warranted.” There is also little transparency in the POD industry, causing confusion regarding their actual prevalence.
When discussing tort reform, it is important to keep in mind that not all physicians are acting in their patients’ best interests. Any reform that limits the right to bring suit and recover appropriate damages also protects physicians who, whether intentionally or not, are causing serious injuries by performing high risk procedures in order to receive income through their POD.