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Re: online cash for docs

Subject: Re: online cash for docs
From: "Howard McCollister"
Date: 22 Sep 2005 19:52:10 -0500
Newsgroups: sci.med
"fresh~horses" <fresh~horses@xxxxxxxxxxxxx> wrote in message 
news:1127368144.655966.225210@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
>
> Howard McCollister wrote:
>> "fresh~horses" <fresh~horses@xxxxxxxxxxxxx> wrote in message
>> news:1127355294.463304.125120@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
>> >
>> > Howard McCollister wrote:
>> >> "fresh~horses" <fresh~horses@xxxxxxxxxxxxx> wrote in message
>> >> news:1127334372.002619.148180@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
>> >> > http://www2.epocrates.com/index.html
>> >> >
>> >> > Check the "Honors" box on the left.
>> >> >
>> >>
>> >> epocrates is generally small potatoes for honoraria, as are most of 
>> >> the
>> >> online offers. I, and most doctors I know, get such invitations by 
>> >> email
>> >> and
>> >> regular mail at least a couple of times every week - fill out a survey 
>> >> by
>> >> phone or mail and get $100. Drug companies mostly, but some equipment
>> >> manufacturers and some marketing firms. Then, there are various other
>> >> consulting agreements, usually involving money plus travel expenses,
>> >> honoraria for speaking engagements....stuff like that. It's nothing
>> >> new...been going on for many years now.
>> >>
>> >> HMc
>> >
>> >
>> > It's nothing new been going on for years now...
>> >
>> > That makes it ok?
>> >
>>
>> No, that doesn't make it OK. I think it's intrinsically OK, all by 
>> itself.
>>
>> HMc
>
>
>
> A couple questions related to a comment in your post to Harris ie)
> "early adopters".
>
> What does that mean?
>
> And preceptorships...what does that mean?
>
> And when you say teach ... do you mean teach for the pharma device
> manufacturing company? Or teach for your surgery colleageus at Cayuna?
>

Surgery these days is increasingly technology-driven. In many cases, a 
particular operation can't be done using minimally invasive techniques until 
someone invents a tool make if safer, or to make it possible at all. The 
days of being able to do modern surgery using the same tools that 
Halsted/Halstead used are long gone, as of  1989, the day that Eddie Joe 
Reddick did the first laparoscopic cholecystectomy in the US. There are all 
kinds of technologies being invented, studied, FDA-approved, and then they 
make their way into the medical market. Those companies then have to sell 
the technology to surgeons.

My partners and I are committed laparoendoscopic surgeons. We tend to stay 
at the leading edge of advanced laparoendoscopic technique and as such, 
there are a number of operations we do that very few other surgeons around 
our part of the country are doing. We evaluate the technologies that are out 
there in order to find a better or safer way for us to do a particular 
operation, and in some cases we participate in the development of those 
technologies with a variety of different companies. We get paid for sharing 
our expertise with those design teams. In cases where we have greater 
experience with a particular operation than other surgeons, those surgeons 
may come to our hospital and we will teach them (preceptorship). Most of 
these companies have several other such teaching arrangements. In other 
cases, we may be invited to speakand/or teach at other such training 
courses. As I type this, I have my feet up on the balcony of a very nice 
hotel overlooking the Hollywood hills in LA. I drove up this morning from 
San Diego. Dinner at Spago tomorrow night.

Bear in mind that these companies with whom we have consulting agreements 
have sought us out because we are already using their equipment - we didn't 
start using their equipment because they gave us money. As an example, we 
have a consulting agreement with one particular device company that makes 
surgical staplers, and we teach surgeons how to do advanced laparoscopic 
operations using those staplers. That same company makes an ultrasonic 
scalpel and they would dearly love for us to buy it and use it in those 
teaching courses. We don't, and use a competing company's ultrasonic scalpel 
because we think it's better. It's a sore point with the first company, and 
it creates a fair amount of friction in our relationship.

HMc




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