I'm not even supposed to BE here today!I'm not even supposed to BE here today!

If you haven't seen the story yet, the headline is scathing, focusing on perceived greed of the orthopedic community. It reads, "Top Spine Surgeons Reap Royalties, Medicare Bounty." The Wall Street Journal article explores how Medtronic awarded royalties to spinal surgeons at Norton Hospital (Louisville, KY). From 2004 to 2008, says the journal, Norton performed the third-most spinal fusions on Medicare patients in the country. To complicate the issue, five surgeons at the hospital are also among the largest recipients nationwide of payments from Medtronic.

In the first nine months of 2010, the surgeons—Steven Glassman, Mitchell Campbell, John Johnson, John Dimar and Rolando Puno—received more than $7 million from the company.

Of course, WSJ got this information directly from Medtronic, which began disclosing the payments in advance of the Physician Payment Sunshine Act set to take effect in 2013.

The device in question is the morphogenetic protein-2, known as BMP-2—which has been increasingly used spinal fusion surgery. According to the Journal Sentinel, "There is no evidence any of the surgeons who have published articles on BMP-2 received royalties they did not deserve. However, the spinal surgery field has been plagued by troubling questions about transparency."

Transparency is just one part of a complicated issue, but its probably the one that will effect device makers the most. The Physician Payment Sunshine Act is important legislation under the Patient Protection Affordable Care Act. It requires companies to begin recording any physician payments that are worth more than $10 in 2012 and to report them on March 31, 2013. That includes stock options, research grants, knickknacks, consulting fees, and travel to medical conferences. The details will be posted in a searchable database starting Sept. 30, 2013.

The best advice that I can offer is that device firms should be prepared to have their practices questioned. With any luck, you've kept your dealings with physicians above-board. This industry needs physician collaboration and it would disastrous to have it taken away due to suspicious practices.

"It seems to never occur to fools that merit and good fortune are closely united." —Johann Wolfgang von Goethe

—Heather Thompson