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Greed and Fame

Jupiter, Jesse MD

Techniques in Hand & Upper Extremity Surgery: June 2009 - Volume 13 - Issue 2 - p 59
doi: 10.1097/BTH.0b013e3181a9cc57

From the Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA.

Address correspondence and reprint requests to Jesse Jupiter, MD, Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Yawkey Center for Outpatient Care, 55 Fruit Street, YAW-2-2C, Boston, MA 02114. E-mail:

As our profession reels from ever-increasing regulations, restrictions from industry support, and more and more expansive disclosure forms, it is not surprising that the reaction from most is "Why me?" After all, we are dedicated physicians, devoted to our patients, producing quality education, and engaged in state-of-the-art research-do we not also have the highest degree of integrity? Well, when looked at from "30,000 feet," one might agree for most of us, but likely, not for all.

Although society still elevates the physician (perhaps not as high as before), we are still human and subject to similar strengths and flaws as any other group or profession. Self-promotion and self-aggrandizement are certainly not new developments. It is said that the noted French surgeon Ambroise Paré insinuated himself into the French court, not just because he cured the King's hemorrhoids but because his skills enabled the previously barren queen to conceive-9 times. Of note was the striking resemblance of the King's offspring to his court physician!

Although I have never accepted personal royalties for my own development efforts with medical industries, I have all too often tasted the fruits of numerous dinners, outings, banquets, and the like. Sure, we should be rewarded for our intellectual property, but many are now asking how much is enough. Are 7-figure annual royalty payments a bit over the top when one's own department searches for adequate funds?

How often have our own clinical researches, presentations, or publications been tainted, even subconsciously, by our interest in producing excellent outcomes of surgical procedures to self-promote ourselves as "supersurgeons"? I just reviewed three separate publications on the surgical treatment of a proximal humeral fracture with a specific "locking plate." All involved large numbers of patients, with 2 having substantial complications, whereas the third touted a 100% union rate with a high degree of patient satisfaction. One has only to wonder how often this is done, how surgical texts illustrate procedures that seem so simple, and how too many of us have become spokespersons for the industry when we simplify our trade.

New technology is adopted sometimes without truly understanding the clinical data or even the methodology to promote ourselves as the "first on the block." I was recently reminded of this once again after producing what I understood to be an "instructional" video of a new technology, only to see the video used as a promotional tool by the industry at the AAOS without my written permission or any disclosures on the video. I really should have known better, but perhaps this is an example of my subconscious interest in self-promotion!

Will this "firewall" that is building between physicians and the industry hurt our educational and research activities? For sure! Will we be able to develop alternative methods? Very likely, although undoubtedly painfully and without the free tote bags, lunches, or ballpoint pens.

Please do not get me wrong. We are still a noble profession and represent an enormously important role in society. We are all painted in this broad brush and need to reaffirm our values and all of the wonderful things we do everyday to our patients and families.

© 2009 Lippincott Williams & Wilkins, Inc.