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Be aware of new importance placed on disclosure, transparency in orthopedics
Chief Medical Editor Douglas W. Jackson, MD, asks Lanny L. Johnson, MD, about integrity.
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Disclosure and transparency for speakers at our national meetings and authors writing articles for orthopedic journals have become more formalized processes. For this interview I have turned to a friend and innovator, Lanny L. Johnson, MD, to ask 4 Questions related to the importance currently placed on these values. He has dealt with these issues in depth throughout his career and agreed to share some of his thoughts with our readers.
Douglas W. Jackson, MD
Chief Medical Editor
Douglas W. Jackson, MD: It was once believed that orthopedists should not accept royalties from companies. How can anyone consider being paid for one’s intellectual properties and hard work unethical?
Lanny L. Johnson, MD: It is not unethical to earn from your ideas and or work: It never should have been considered so. It certainly is not when business standards of value are applied.
To point out how things have changed, in 1975 when I conceived the “keyhole” cutter that became the meniscus cutter, I did it as a free-will offering. I had never taken any money from Dyonics nor did I intend to do so. I was taught in my residency that any financial arrangement with a company was unethical.
About the same time, Hugh Smith, MD, gave his famous, although now-forgotten, lecture at the American Academy of Orthopaedic Surgeon’s (AAOS) annual meeting on “Orthopedic Payola.” In it, he pointed out the abuses that were going on in orthopedics. If he had lived longer, he would have never conceived what was to come in “Orthopedic Payola.”
Back to my story ... One Saturday I received papers that asked me to sign my rights away to the patent that I submitted for the keyhole shaver. I was surprised, not knowing that a patent had been submitted without my knowledge, since it was 100% my idea as was the art that secured the patent on the entire shaver system. However, the patent law protected me: everyone who contributes to a patent must be listed on the patent. The people at the patent office told Dyonics, “We do not believe you could have done this absent a surgeon.”
I was insulted and figured they changed the game. My name went on the patent and after some negotiations I received market royalties.
Jackson: What obligations do innovators of orthopedic devices have to their fellow orthopedists?
Johnson: I have recently thought this over and have a reaction to the now standard requests for honesty — now called transparency in politically correct speech.
The AAOS and the Arthroscopy Association of North America (AANA) now require a slide revealing the speaker’s relationships with industry prior to any presentation. I appropriately indicate Lanny L. Johnson Family, the name of my business entities; LLJMD, LLC, Information Health Network, and www.Prudent-Inventor.com.
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However, I further list my motive and obligations in subsequent slides. I list my general motives as to benefit by my efforts, my knowledge, my willingness to share and my experience and to benefit the audience. I list my motives as to share what I have learned, expose swindlers, protect the naïve, educate the doctor and help the inventor. I list unanticipated motives as personal financial gain, professional status elevation, affiliated company gain and institutional recognition.
The next slide lists any and all obligations I might have related to the presentation. I state it is a free-will offering, without obligation to any contract, money, institution, or corporation. There is not personal, professional, unwritten, unspoken or hidden obligation of any kind.
I think these are the things our colleagues need to disclose. Just listing relationships is not transparency.
Jackson: Integrity sells, but how does one define integrity in a salesperson?
Johnson: Integrity in a salesperson happens when they disclose, if it is not already understood, that he/she is seeking a benefit from the sale. However, they are not seeking solely their benefit, but the benefit to the purchaser. A full disclosure of the pros and cons of the product are important. Perhaps a better perspective is to not sell anyone who is not first a buyer. This is known as qualifying your customer. Properly done, a full disclosure will only enhance the prospect of this sale and subsequent ones as there is loyalty associated. In business we build a relationship upon communication.
Jackson: How do young orthopedic surgeons with new innovative ideas protect their potential intellectual properties?
Johnson: They should listen to my lectures, get a copy of the handout that was given at the AANA Specialty Day meeting or go to www.prudent-inventor.com.
For more information:
- Lanny Johnson, MD, can be reached at P.O. Box 975, Okemos, MI 48805-0975; 517-285-1812; e-mail: lljmd@aol.com. He has a financial interest in www.prudent-inventor.com.