“This is the latest whiz kid among stents. Nowhere else in the world you will have a stent like this. I have done 56 cases. No complications at all. Affordable too”
This is not a medical rep making a sales pitch but an interventional cardiologist addressing colleagues at the National Interventional Council (NIC) 2017 conference in a five-star hotel in Delhi.
Product placement in movies or television serials is old hat. But how about product placement during the live streaming of a medical procedure? Bizarre as it sounds, this is happening at medical conferences. In every live case at NIC 2017 — with or without the moderator’s prompting — the cardiologist doing the procedure announced the brand name of the product he was using and extolled its virtues. There was a scroll display of the product on the screen as well.
In fact, the preference for live cases, even though it increases risk to patients, over pre-recorded cases is because companies manufacturing devices pay handsomely for their products to be featured during these ‘live’ performances. NIC 2017 came soon after India Live 2017 in February, yet another major cardiology conference that boasted 30 live cases. So, many of the multinational companies that shelled out crores as sponsorship for the first event were unwilling to support NIC 2017 to the same extent. Hence, one of the major sponsors of NIC 2017 is a Chinese stent company, a relatively new entrant in India.
Senior cardiologists, who had earlier strongly supported multinational stents on the grounds that they had FDA approval, were happily promoting the latest entrant which does not have FDA approval, and which they obviously have little experience of using.
Not all doctors are comfortable with the practice of pushing products. Several cardiologists expressed their reservations to TOI but said they were helpless to stop it as it brings in huge amounts of money to organisers of these conferences. Also, the organisers are often “big-daddies” in the discipline. Both cardiologists and device manufacturers pointed out that brand boosting in livecasts happened in other surgical disciplines like gastroenterology, neurology and orthopaedics.
Dr Amar Jesani, one of the founders of the Indian Journal of Medical Ethics, is a strong critic of live surgeries. “It raises risk for patients. Why can’t it be pre-recorded if they want to use it for teaching purposes? But surgeons are flamboyant and want to show off their skills. Are doctors salespersons of the company to be promoting a specific product? The code of ethics says doctors cannot take money to promote a product. With the medical council exempting doctors’ associations from the code, the companies pay the organisers or associations instead of individual doctors,” said Dr Jesani.
There was no response from the organisers of NIC 2017 despite several attempts to get in touch with them. Live operative workshops are allowed under the Indian Medical Council Act if these are not for personal monetary gain. However, most international surgical conferences have only cadaveric workshops, deconstruction of videotaped surgeries by master surgeons, and peer-reviewed video presentations filmed in simulation laboratories.
Among those that have banned the practice from some or all of their meetings are the American Association for Thoracic Surgery, the American College of General Surgeons and the American College of Obstetrics and Gynaecology.