Re: Financial ties between leaders of influential US professional medical associations and industry: cross sectional study
The article recently published in the British Medical Journal (BMJ) regarding the financial relationships between industry and the leadership of various medical specialty societies based in North America is notable in that the Orthopaedic Trauma Association (OTA) is the only orthopaedic organization included in the study(1). The reason for this is unclear, but since we are included, we feel it is appropriate to respond. The OTA would like to compliment the study authors on shedding more light on what we have always considered to be a topic that demands full disclosure and transparency. The OTA has, as a fundamental policy, always considered full disclosure of industry relationships a primary responsibility of all presenters, authors, and OTA governance groups which is inclusive of the OTA Board of Directors, Committees, Project Teams or other official OTA groups. This includes mandatory full disclosures updated annually at a minimum in the AAOS disclosure database, with an expectation that any changes will be reported as soon as possible after they occur. Disclosures from the leadership are included in the agenda book for all Board of Directors meetings, OTA Annual Meeting presenters have a mandate to provide all relevant disclosures on the second slide of any talk or instructional lecture, and members of OTA governance groups must disclosure any pertinent industry affiliations prior to any leadership discussion. We invite a review of the OTA’s disclosure policy(2), which is available on the OTA website.
An associated editorial mentions the “recruitment” of leaders to the OTA or other medical societies be free of any industry ties(3). It is important to recognize that the attainment of a leadership position is a careful progression of graduated responsibility in the organization that typically involves hundreds (if not thousands) of hours of dedicated, unpaid work prior to attaining that level. It attracts individuals from an already highly competitive field who are altruistic and innovative, with excellent communication and leadership skills. It is only natural that, in a highly technical field such as orthopaedic surgery, these individuals would also be involved with industry for the research, design, and implementation of products that have, in general, vastly improved the lives of the patient population we serve. These relationships are especially important since in the field of orthopaedic trauma, despite the high impact in terms of disability that society experiences from the injuries we treat, we are chronically underfunded by traditional granting agencies(4). We would emphasize that the majority of payments detailed in the article were for the conduct of research, from which, in our field, the principal investigator rarely if ever draws any remuneration. In this regard, our society has heavily promoted high quality, unbiased, prospective and randomized trials with complete investigator independence that are integral to making evidence-based recommendations for investigation and treatment of traumatic injuries.
Lastly, although in our opinion there is an unnecessarily negative tone to the presentation of the facts in the article, it is an important reminder to us that the OTA stay vigilant in our disclosure processes, transparent in our interactions with industry, and tireless in our efforts to demonstrate the benefits of these relationships to those we are ultimately responsible to, our patients.
Michael McKee, MD
President, Orthopaedic Trauma Association
Sent on behalf of the OTA Board of Directors
1. Ray Moynihan, Loai Albarqouni, Conrad Nangla, Adam G Dunn, Joel Lexchin, Lisa Bero.
Financial ties between leaders of influential US professional medical associations and industry: cross sectional study. BMJ Open, Feb 2019. https://bmjopen.bmj.com/content/9/2/e025864
2. OTA Disclosure Policy: https://ota.org/sites/files/2018-04/OTA-Disclosure-Policy_0.pdf
3. Jake Checketts, Matt Vassar. Editorial: Financial relations between leaders of US medical
societies and industry New data shed sunlight on how to create doctors’ organizations that we can trust. BMJ Open, 27 May 2020. https://www.bmj.com/content/369/bmj.m1811
4. P Hoogervorst, D W Shearer , T Miclau. The Burden of High-Energy Musculoskeletal Trauma in High-Income Countries. World Journal Surgery, 2020 Apr; 44(4):1033-1038.
Competing interests: Michael D McKee, MD, FAAOS, FRCSC (Phoenix, AZ) Submitted on: 01/24/2020 Acumed, LLC: Paid consultant Bioventus: Paid consultant Canadian Orthopaedic Association: Board or committee member Elsevier Inc: IP royalties Exactech, Inc: Paid consultant ITS: IP royalties; Paid consultant Journal of Orthopaedics and Traumatology: Editorial or governing board Nexsens: Paid consultant Orthopaedic Trauma Association: Board or committee member Orthopedics Today: Editorial or governing board Springer: IP royalties; Publishing royalties, financial or material support Stryker: IP royalties; Paid consultant Wolters Kluwer Health - Lippincott Williams & Wilkins: Publishing royalties, financial or material support Wolters- Kluwer publishing: IP royalties