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[Walnut Beast]

Physician owned distributors. Is your surgeon part owner in the company that makes the parts being put in you??

https://www.investigatetv.com/2022/05/23/operation-profit-some-surgeons-pull-millions-by-owning-medical-device-companies/

[beenthere]

Sounds like a rather negative piece towards surgeons, from those jealous of someone making more money than they do. 

Maybe, just maybe, the surgeons work with different manufacturers of parts because it is the surgeon who knows what these parts need to do and how they have to fit into the incisions. Only these surgeons (not the plant engineers) know what is going on inside the body. 
Would not be unusual at all that a surgeon is named on a patent for an implant or a tool that does the job (or know what is manufactured and does not do the job).

 

[kantuckid]

On the outside looking in- I'm more concerned that my doc makes the best possible choice as to what's (and how)placed in my body, rather than who owns the stock, albeit him or her or somebody else. 
Taking a more positive viewpoint: Any doc that has invested in a joint maker is showing confidence by owning some of the company? What's wrong with that idea? 

[YellowHammer]

I know that the two major joint replacement centers in our city each use only the parts that their center is affiliated with or sponsored by.  I've had that discussion with them before, and one of the reasons I changed doctors the hospitals in the past.  "Which parts do you use?  Who makes them?" Of course, each doctor says the parts they use are the best, but certainly, they are limited to whatever their hospitals are affiliated with. 

I don't know if they get stocks or investments from each, I never asked them, it may be against the hospital policies, maybe not.

Of equal importance, each manufacturer has an assisting surgeon who backs up the primary surgeon, helps fit check their manufacturer's parts, and otherwise has as much, or more experience than the actual surgeon doing the job.         

[doctorb]

This issue brings up a real potential for unethical behavior.  Many hospital systems permit the use of devices designed by their docs, but do not allow them to collect royalties on those products when they are inserted by the designer.  That's a huge conflict of interest.

Secondly, and specifically regarding hip replacement components, the anatomic shape of the individual should determine what components are used.  Not all systems on the market are the best for all of the variabilities in our anatomy.  Your doc needs to do what's best for you...not what is also best for him/her.

Again, as a patent holder on an Orthopaedic device, I never received a dime when I inserted it.  The device never received widespread use, and, as in all things, newer advances shelved it.  The process was interesting, however.  

As many docs are now employees of hospital systems, the hospital system can also benefit from the use of such devices, creating a conflict of interest on their part as well.  I do believe, however, that the vast majority of excellent surgeons only want the best for their patients.

[kantuckid]

One device factoid I ran into during covid was that dentists and oral surgeons use each other via services rendered referrals and a crown cannot go on a wrong brand implant. 
Given the mobility factor of our population this seems downright dumb to me as people must find a new dentist. May also be an issue for service members (In my day there were no implants done by Army dentist so I suspect it's a brand issue now given the brand variations.)
 as crowns are not permanent to begin with. 
 Given the covid shutdowns non-covid medical care suffered of course and is still such as appts. are far in the future as it never seems to catch up. My eye doc seems to be an exception as they maybe didn't get diverted or shut down as long.
My neighbor was a contractor who fell off a ladder and broke his hip before the newer hip joints came out. I think he's on his 3rd one now which is likely a modern one. With joints replaced is the hardware a factor brand wise for those who need one half redone or have an accident? Seems some of the same issues as those who move with a certain brand of dental implant would have but with less frequency than dental work. 
Reminds me of part sourcing for vehicles to some extent. Windshields for one e.g., come in different grades. Does a rich guy get a better hip joint brand than me on Medicare Supplemental or a Medicaid patient? We all know a movie star gets a dentist that does wonders for their smile & more. ;D

[doctorb]

There are brand specific replacement parts for revisions of THR.  They are not necessarily generic and modular, meaning they do not necessarily fit other brands.  It's important to keep a record of exactly what the last surgeon put inside you, to make this next revision go easier, if needed. Most adept total joint surgeons understand and are facile with the small variations in the implants and their instrumentation among brands, and this doesn't necessarily mean you have to find a doctor who wears the right color jersey for your total joint to be revised.

[Walnut Beast]

Sounds like a rather negative piece towards surgeons, from those jealous of someone making more money than they do.

Maybe, just maybe, the surgeons work with different manufacturers of parts because it is the surgeon who knows what these parts need to do and how they have to fit into the incisions. Only these surgeons (not the plant engineers) know what is going on inside the body.
Would not be unusual at all that a surgeon is named on a patent for an implant or a tool that does the job (or know what is manufactured and does not do the job).

Tell that to the son that lost his mother and the Surgeon that went to prison in one case. He has also went to Washington to talk to the senate. From what I gathered from the piece on tv was it was working both ways. Some that used their own products were more careful and confident in the quality of them. Then the other camp that were greedy and wanted to put more of the parts in the patient than needed

[doc henderson]

the problem with these highly detailed products is who do you want making these designs, a 24 y/o engineer working for a company, or a guy that uses a variation and has years of education, and experience, and makes a modification.  If it is really better (usually solves an issue and improves success using the item) do you want the doc who had the insight to make it better, use an older version?  

[Ianab]

he problem with these highly detailed products is who do you want making these designs,

That was my thought too. Who actually has the training AND real world experience to design and improve these parts?  Realistically it's going to be surgeons AND a team of Engineers (that understand the metallurgy  / mechanics / manufacturing ).  But no way I'd want an implant from the cheapest bidder in Asia. If there aren't actual experienced surgeons involved (as management or consultants) then who knows how well something is actually going to work? 

[kantuckid]

the problem with these highly detailed products is who do you want making these designs, a 24 y/o engineer working for a company, or a guy that uses a variation and has years of education, and experience, and makes a modification.  If it is really better (usually solves an issue and improves success using the item) do you want the doc who had the insight to make it better, use an older version?  

If I were debating this subject, knowing what I know, which is damned little about medical stuff, I'd argue that far more people die from poorly designed auto parts than medical devices. As an aviation mechanic I was witness to how great care in both work process and parts can take place. Much less so when I worked on road vehicles.
As a skilled trades person in industry, we worked hand in hand with engineers who were also our favorite whipping post, as it were. That said, I'd vote for the 24 year old "sometimes", not always... :D
My thoughts say that 24 yr old engineer should be working hand in hand with that doc! Not one, vs. the other. ;)
When you have three sons who are all trained, skilled, experienced, engineers and not one is nerdy, you probably tend to feel that way. They do ask me about practical stuff sometimes and try to impress me as to how they can execute hands on/DIY projects. 
 
 

[doc henderson]

engineers are good at DIY projects, but it takes them weeks to do a one-day job.    not all docs are good at it either, but it is the ones that have a knack at paying attention to detail and finding the problem and solution.  cardiac catheters are a good example.  some docs do ok, and a few are very talented.  the really talented ones are conceptual and can solve problems the others did not know existed.  I agree, then turn it over to the engineers for details but it is hard to improve a tool you do not know how to use. ;)