The bombshell lawsuit against Sioux Falls surgeon and medical device maker Wilson Asfora and Sanford Health for millions of dollars in alleged Medicare/Medicaid fraud and unnecessary spinal operations cites this 2016 report from the Senate Finance Committee on “Physician Owned Distributorships.” According to the report, PODs are “physician-owned entities that derive revenue from selling, or arranging for the sale of, implantable medical devices ordered by their physician-owners for use in procedures the physician-owners perform on their own patients at hospitals or ambulatory surgical centers.” Wilson Asfora’s Medical Designs LLC is a physician-owned distributorship.
In its report, the Senate Finance Committee found PODs “most prevalent in the field of spinal surgery” and focused on that particular medical field. The committee expressed great concern about the potential for conflict of interest among doctors recommending procedures involving surgical implants which they themselves design, own, and profit from:
Surgeons have a unique and powerful role in influencing both patient and medical practice decisions. When a surgeon recommends surgery, patients are strongly inclined to follow their doctor’s recommendation. Within the field of spinal surgery, spinal fusions are among the most serious and costly types of back surgery, and are typically only recommended for patients with the most serious back problems. Spinal implants are generally “physician preference,” meaning hospitals typically purchase the devices recommended by their surgeons. Spinal surgeons therefore have significant influence over both the frequency of spinal fusion surgeries and the devices used in those surgeries.
Unchecked, this position of power can give POD spinal surgeons the opportunity to grant themselves a steady stream of income by increasing the use of the products supplied by their POD. PODs present an inherent conflict of interest that can put the physician’s medical judgment at odds with the patient’s best interests [Senate Finance Committee, Majority Staff Report, “Physician Owned Distributorships: An Update on Key Issues and Areas of Congressional Concern,” May 2016, p. 1].
The committee found surgeons involved with PODs performing more surgery than surgeons without a financial stake in spinal implants:
Our analysis found that:
- POD surgeons saw significantly more patients (24% more) than non-POD surgeons.
- In absolute numbers, POD surgeons performed fusion surgery on nearly twice as many patients (91% more) as non-POD surgeons.
- As a percentage of patients seen, POD surgeons performed surgery at a much higher rate (44% higher) than non-POD surgeons.
- In absolute number, POD surgeons performed nearly twice as many fusion surgeries(94% more) as non-POD surgeons.
These findings quantify, for the first time, the extent to which POD ownership influences the behavior of individual physicians [Senate Finance, May 2016, p. 2].
The Senate Finance Committee issued this report in May 2016, just three months before the two whistleblower doctors filed their original complaint against Asfora and Sanford.
“4. In absolute number, POD surgeons performed nearly twice as many fusion surgeries(94% more) as non-POD surgeons.”
Holy moly! That’s incredible! I guess the first question to ask a spine surgeon is, do you have a financial stake in this specific device? Or try to discover such from one’s own research.
This is one of the reasons why Mayo Clinic doctors are paid straight salary Instead of fee for service. Where were the Sanford auditors in all of this? That’s what I would like to know.
Whenever there is an unusual volume of physician services being done, there is more times than not some scam going on like this. Stace was Trusting his intuition when this doctor was pushing an unneeded surgery on him.
Or look at the size of the luxury physician owned facility. I am starting to wonder whether knee surgery comes in elite or just plebeian sizes to fuel the mill? Guess which one gets you back to ultimate performance and which one is just a $15k band-aid?
https://m.youtube.com/watch?v=Qfl_aUsTcQQ
This is where science has come to in the US of Corrupt Capitalism