Friday, November 08, 2013

Mixed feelings

On the one hand, kudos to Lenox Hill Hospital’s Chair of Urology Dr. David Samadi, who highlighted the importance of early screening and prevention by performing prostate exams live on NBC Today Show anchors Matt Lauer and Al Roker. Helping people understand the ease of this screening test is a public service.

On the other hand, this is the same Dr. Samadi who permitted himself to appear in a testimonial video produced by Intuitive Surgery (posted on August 28, 2013) to support its marketing campaign for use of the daVinci robotic surgery machine, specifically by playing on men's fear of impotence and incontinence. His statement--"There's a huge benefit to patients when they go through the daVinci prostate surgery"--is not supported by scientific inquiry. This video was posted in the midst of numerous reports and concerns about the use of this technique.

Recall this report by Citron Research, on December 19, 2012:

Imagine a medical company with a single product — one which lacks any clinical data proving medical efficacy superior to other conventional treatments.

And another particularly damning report from Citron in October 2013:

In over 12 years of publishing probative stock research, Citron is most proud of the work we published on Intuitive Surgical (NASDAQ:ISRG) starting last December. Not because the stock suffered a decline of over 30% amidst a record- setting bull market, but rather because we helped raise to the forefront of public awareness the undisclosed dangers of robotic surgery and the subsequent dilemma: what happens when medical best practices collide with unbridled thirst for profits.


Anonymous said...

Recall the USPTF gave the PSA screen a letter D rec, and recently, the AUA pulled back and an endorsed a more pragmatic approach to screening.

PSAs and television appearances help in educating public for appropriate tests, especially with high profile celebs. But best intentions can spill over and blur lines between helpful and hurtful screening. most folks see the words TEST and CANCER and the next thing you know post screen, they have an appt to the OR.

e-Patient Dave said...

Should I note that encouraging men to get screened is sure to increase the number who get treated?

Thank you for repeatedly making this point clear - the unproven value of the frickin' robot. I learned recently of a town with a little 50 bed hospital who just got a Da Vinci - because THEIR PUBLIC was going elsewhere to find one!

We can't solve this genuine business problem by guilting management - if medicine's going to be consumer driven, then problems like this require solving consumer misinformation. How can we get THIS message onto the Today Show??

Anonymous said...

I believe the AMA should ban the appearance of physicians in any advertisements, even 'infomercials'. Certainly the ones like Intuitive's ads. Enough is enough - don't lend the weight of your degree to someone trying to sell something. Ethical relativism in the profession is killing us.

nonlocal MD

Anonymous said...

Those that use the robot as the source of the majority of their revenues are clearly seeing the effects of the USPTFS warnings as the prostate cancer referrals related to PSA screenings continue to fall.
They will continue to tout the benefits of their treatments

anonymous MPH

Anonymous said...

Regardless of the screening issue, it appears the evidence against the robot is accumulating:


Anonymous said...

Having had minimally invasive surgery with the Da Vinci system I could safely say I would not have done it different if I had to do it again. My recovery compared to other surgeries was minimal. A week later I was back to work and had my life back. I like hearing what doctors and patients alike have to say. How else would we educate ourselves? Don't see a problem with these videos. Also, we need to start embracing this new technology and not be afraid of it. We cannot stall great ideas and expect to advance.

nonlocal patient

Paul Levy said...

I'm so pleased you had a good experience. Anecdotes, however, don't help us make scientifically valid judgments about clinical efficacy when we want to compare one form of laparoscopic surgery to another.