Introduction

Physicians have long partnered with the medical device industry to innovate and, in so doing, have improved healthcare. The NeuroInterventional specialty has seen considerable advancement as industry has brought new tools to the field. Indeed, one of the seminal devices created for the specialty had a physician's name embedded in it.1 The authors believe that consulting relationships between physicians and industry have been important in the development of many of the products in routine use and have thus inured to the benefit of NeuroInterventional patients.

In recent years these relationships have come under increasing scrutiny as a host of industry players and their physician counterparts appeared to cross the line of appropriate behavior. For example, in 2007, five leading manufacturers of hip and knee replacements entered agreements with the US Department of Justice (DOJ) to avoid prosecution for providing improper financial incentives to induce orthopedic surgeons to use the company's products. In 2008 an Arkansas-based neurosurgeon pleaded guilty to soliciting and receiving kickbacks from a medical device manufacturer. In addition to relinquishing his medical license, he agreed to a $1.5 million settlement of related civil charges. In all of these cases, kickbacks were paid in the form of excessive consulting fees and related travel and hospitality. In 2010 a prominent Maryland cardiologist was investigated by the Senate Finance Committee for allegedly defrauding Medicare by performing unnecessary stent procedures. In its report the Committee focused heavily on the physician's relationship with the stent manufacturer, and concluded that hospitality and consulting fees provided by the manufacturer may have encouraged the physician's overutilization of the devices.2

Previously, members of industry have come together to implement codes of ethics specific to their industries—for example, the MITA Code of Ethics for the medical imaging industry, the PhRMA Code for the pharmaceutical industry and …