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PODs Spark a Political War

Joe Cantlupe, for HealthLeaders Media, June 16, 2011

At this point, the matter of physician owned distributorships is another Washington D.C. tale of political intrigue. Whether it becomes spine-tingling remains to be seen.

The Senate Finance Committee is looking into PODs, signaling what may be an all-out government assault on the highly controversial practice, with questions about the role of physicians and medical device chains, and opposing high powered law firms in the fray and big-buck physicians as big targets.

Or it may fall flat.

""It is a complicated issue,"" the committee states. No kidding.

The issue is churning in the wake of a Senate Finance committee report issued last week, Physician-Owned Distributors: An Overview of Key Issues and Potential Areas for Congressional Oversight. The report says that under PODs physicians act as middlemen between manufacturers and hospitals or surgical facilities, in lieu of manufacturer representatives.

The committee noted, for example, that there was a marked increase in spinal fusion surgery with the expansion of PODs, and it cited examples of patients put at risk. The suggestion is that physicians are exerting undue influence.

I've spoken to both sides of the debate. POD critics say growing numbers of physicians are improperly making big money in spine and total joint replacements, and are branching out to other areas such as cardiac implants, pacemakers, and defibrillators with their questionable links to device manufacturers. Patients are paying the price, critics say, in a practice that "smells to high heaven."

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