A Gynecologist Makes an Appeal to His Colleague: Don't Be Seduced By Manufacturer Sales Pitches and Incentives
Dr. Julio Novoa is an OB-GYN based in El Paso, Texas. For some time, he has been speaking out on behalf of women who have been injured by the Essure contraceptive device, manufactured by Bayer's Conceptus division. He and other advocates run a website dedicated to providing information about Essure as well as a Facebook support group.
Dr. Novoa and his fellow advocates frequently travel to rallies and press conferences at their own expense in order to raise awareness. Last year, when Bayer finally got around to issuing a “Black Box” warning on the packaging for Essure (after being forced to do so by the FDA), Dr. Novoa was also the one who pointed out that his fellow OB-GYNs could still bear liability if they fail to get informed consent from a patient before implanting the device.
Recently, Dr. Novoa published an open letter to his colleagues that has been reprinted on different websites, expressing grave concerns over the way the medical device industry in general and Bayer in particular has been using sales pitches and “incentives” (i.e., bribes) in order to influence well-meaning physicians and convince them to use their products.
The main problem, according to Dr. Novoa, is that doctors with large numbers of patients and hectic work schedules simply don't have time to do their own due diligence. At the same time, they are subjected to high-pressure sales tactics by company representatives whose employment is contingent on how many units they are able to sell – and thus, tout only the product's advantages and say nothing about the risks or side effects.
In general, companies that put out these devices offer free training, miscellaneous “perks” and advice on how to bill insurance companies as much as possible when using these products. In the case of Essure, there is also the matter of how quickly and easily the device can be implanted as compared to performing a traditional (and safer) tubal ligation. Putting in an Essure device can be done in a physician's office as a minor outpatient procedure, whereas a tubal ligation requires full surgical facilities in a hospital. Dr. Novoa points out:
“When one factors in the time and effort spent performing a traditional tubal ligation, a GYN doctor may be paid about $100 per hour. By comparison, a doctor may earn $100 per minute for performing the Essure procedure.”
Between the financial incentives, reputed ease of use and a high physician workload, many OB-GYNs simply accept the glowing sales pitch – and fail to perform their own due diligence.
Unfortunately, as history and experience clearly demonstrates, companies such as Bayer have too much at stake. They cannot be relied upon to be forthcoming about the defects in products that have brought them hundreds of millions, even billions of dollars in revenue. Dr. Novoa says, “I fear the only way to remove the Essure device from the market is through litigation.”