There Will Be Blood and Money
And a lawsuit. And many, many questions about the relationship between a local hospital and the world’s largest medical device company.
In its response to Gossman’s complaint, Lahey denied that any of its doctors had entered into an illegal deal with Medtronic. Perhaps it was a sign of the stakes of the fight that Lahey’s CEO, David Barrett, sent an internal e-mail to employees that described Piemonte and Nesto as “physicians of unimpeachable integrity,” tarred by “false and irresponsible” allegations. Moreover, Gossman was terminated because of “long-standing issues” regarding his behavior at work. -“Although Lahey Clinic is saddened by the litigious actions of Dr. Gossman,” Barrett concluded, “this is an unfortunate sign of the times.”
GOSSMAN’S ALLEGATIONS ABOUT Lahey hit at a particularly sensitive time. When it comes to the relationship between healthcare providers and big businesses, we live in an era of heightened suspicions. Gone are the days when doctors were assumed to be above reproach, when they would (and could) accept meals, vacations, or other gifts from medical companies. Over the past two decades, the government has steadily fortified walls designed to keep industry from unduly influencing doctors’ medical decisions — with good reason. “In terms of the evidence, we know that a gift increases a doctor’s use of company products and services. It just does,” says Harvard researcher Eric G. Campbell, who studies business relationships in medicine. According to several studies, even the free pens that drug companies once handed out were shown to affect prescription patterns. “If it didn’t work,” Campbell asks, “why would companies do it?”
When the Massachusetts Department of Public Health issued additional rules governing doctor-industry interaction last year, it created a regulatory climate widely considered to be the strictest in the nation. For the first time, in this state or any other, the regulations apply not only to pharmaceutical companies — once the most egregious of influence peddlers — but also to medical device manufacturers.
The increase in legislative vigilance has been accompanied by unintended consequences, including the sense among the public, the media, and some academics that any financial relationship between a doctor and a medical device company, regardless of how small, is proof of something nefarious. These days, doctors worry only slightly more about engaging in a real conflict of interest than they do about accidentally creating the appearance of one.
Gossman is well aware of how complicated and angst-inducing the issue has become. He cited the new state rules in his lawsuit, and his portrayal of his dismissal seems almost tailor-made to set off red flags for anyone inclined to be suspicious. In this, he had help from Lahey officials themselves. After being fired, Gossman learned that his house was being watched by private detectives hired by the clinic. Though the hospital has said in court documents that it used them out of fear that Gossman might harass or even hurt his former colleagues, to others the move suggested something far less righteous — an attempt to keep tabs on whom Gossman was talking to. “Dave [had] the means and the motivation to completely dismantle Lahey’s academic reputation,” claims a former colleague.