Wednesday, October 1, 2014

In my post below, I offer some information about payments made nationally by Intuitive Surgery to hospitals and doctors to support the extended use of the daVinci surgical robot.  Here, I take a look at some local examples.  As I searched through the Massachusetts listings, two names popped out as repeated recipients of cash or in-kind payments and services in amounts exceeding $2500:

Jeffrey Spillane,  Southeastern Surgical Associates, in Hyannis, who operates at Cape Cod Hospital; and James Hermenegildo, Truesdale Surgical Associates, in Fall River, who operates at Charleton Memorial and St. Anne's Hospital.

Dr. Spillane is credited as "the first thoracic surgeon to bring Robotic Assisted Thoracic surgery to Cape Cod." His practice website lists the following promotional article in the local newspaper: "A da Vinci for the modern age," Cape Cod Times.  Further, his page at SSA leads patients to this Southeastern Robotic Surgery Web Site and also to watch this Intuitive Surgical-produced video.

For the five months of 2013 data so far reported by CMS, Dr. Spillane is listed as receiving five payments of $3000 or $3500 from Intuitive for "education" along with payments $150 or $300 for food and beverage on the same dates.

Dr. Hermenegildo is credited by Southcoast Health System with introducing robotic single site surgery for gall bladder removal to the geographical area south of Boston.  (I have written about doubts that are raised by Intuitive's hope to expand the daVinci's reach into cholecystectomies.)

This surgeon's reported payments for the five months include three of $2500 each for education, six payments of $500 each for education, and two payments of $150 for food and beverage.

I don't know much about the Intuitive Surgical training program, but I am surmising that personal attendance at educational events provides doctors with the $2500-$3500 fee (along with meals), and perhaps the online modules offer a $500 fee.  Whatever those details, I don't see why it is appropriate for doctors to be paid for education programs by equipment manufacturers.

But, at this point, the issue is not about my opinion.  Neither does this post have anything to do with the technical competence of these doctors, which I assume is at the highest levels.  Instead, the CMS report raises a different type of issue, one at the heart of the doctor-patient relationship. Trust.

In sum, the most important questions can only be answered by patients being served by these two doctors and the thousands of others listed in the Open Payments database:  "Have you been informed that the manufacturer of equipment that is used in one of three possible approaches to your surgery has made payments to your doctor? Do you have any concerns as to whether your doctor's clinical approach to your care might be influenced by the (now reported) financial relationship with this manufacturer?"

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