Cleveland Clinic Part I

Last December the Wall Street Journal ran a series reporting on the relationship among the Cleveland Clinic, the Clinic's CEO Dr. Toby Cosgrove, and medical device companies. The Cleveland Plain Dealer also commented on the controversy. The articles looked at how these relationships create a conflict of interest between financial and patient care concerns at the Clinic.

While at the Clinic, Dr Cosgrove sat on the board of the medical device maker AtriCure, was an investor in the company, and continues to receive royalty payments from the company. The Clinic itself invested $25 million in the company which makes equipment used in an operation to correct atrial fibrillation or heart flutter. Doctors at the Clinic performed the procedure on over 1,200 patients without informing them about the financial ties among the Clinic, AtriCure, and Dr Cosgrove.

Our society has longed recognized the corrupting influence of financial inducements that may conflict with the primary responsibilities of politicians and other government officials as well as many others who are entrusted with providing vital services to the public. The Governor of the state was convicted and fined for accepting a round of golf without disclosing it. Financial services firms pay huge fines for conflict of interest violations that may mislead investors.

Medical professionals, especially, carry a huge responsibility to avoid flirting with the possible corrupting influence of financial ties that may influence patient care. As the Hippocratic Oath says, "I will remember that I remain a member of society, with special obligations to all my fellow human beings."

Personally, I am stunned that Dr Cosgrove and the Clinic allowed themselves to be put into this position, if for no other reason than that it damages the reputation of the Clinic and the trust that patients place in their Clinic physicians. I suppose that, with a board of trustees consisting of about 90 members, many of whom are retired CEOs, no individual member feels much responsibility for the hard job of enforcing ethical behavior.

But if I were one of the 1,2000 patients who have undergone the AtriCure procedure, I would be feeling quite betrayed.