IRS-IN-TRAINING COLUMN by Chad Burk, MD


Fostering medical innovation


“Physicians should strive continually to improve medical knowledge and skill and should make available to their patients and colleagues


the benefits of their professional attainments.” —Principles of Medical Ethics, American Medical Association (AMA), Section 2 (1971)


self-interest.” It is this perspective that “physician-industry collaboration is fraught with deception, manipulation and greed” that endangers the great potential for medical innovation, a goal that the AMA themselves advocated 20 years earlier.


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Physicians are an important source of medical device innovation. Not only do we represent an important source of information regarding unmet clinical needs or how to best improve existing devices for the benefit of the patient, but physicians also contribute directly to discovery by inventing devices themselves. In a study by Chatterji et al., physicians contributed to nearly one in five of the medical device patents filed in the first half of the 1990s. Physician-filed patents were also more impactful as demonstrated by an increased likelihood of becoming a successful device, more citations and follow-on inventions, and a broader scope of influence of the patent as compared to nonphysician patents.


Physician-inventors often rely on medical device companies to develop, manufacture and disseminate products related to the licensed patents. A study by Murphy et al. revealed that patent-holding SIR members attributed contacts in industry and business as one of the top three enablers of their success. Therefore, policies need to maintain the benefits of patient- centered medical device innovation through a symbiotic relationship between doctors and the device industry.


Physician–physician collaboration is also critical for physician- driven device innovation. The top two reported key enablers of physician-inventor success cited in Murphy et al. was personal motivation and mentorship relationships. Social network analysis demonstrated that clusters of well-established physician-inventors within a collection of major research institutions serve as hubs to facilitate medical device innovation. Murphy rationalizes that major research institutions act as gathering points for creative cutting- edge thinkers to collaborate where more complex medical cases and better research facilities stimulate freethinking and novel ideas. Maintaining healthy innovation must therefore also require a concerted effort on the part of higher-level institutions and


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n 1990, the AMA and its Council on Ethical and Judicial Affairs defined appropriate standards of conduct involved in physician–industry collaborations in order to “place the health and welfare of the patient ahead of economic


well-established innovators to support and mentor future medical device pioneers.


A successful model of innovation that incorporates these principles is embodied in the AO Foundation-Synthes collaboration and likely assisted orthopedic surgeons in contributing the greatest number of physician-filed medical device patents in the early 1990s. Founded by four Swiss surgeons, the nonprofit AO Foundation focuses on research and development for treatments of musculoskeletal injuries and provides orthopedic surgeons with hands-on education involving the latest orthopedic implants.


Their success is derived in part from collaboration with Synthes, a for-profit orthopedic hardware company that licenses AO Foundation patents and whose success, in turn, relies on the physician collaboration and innovation occurring at the AO Foundation.


Like orthopedic surgery, interventional radiology is a field rooted in device innovation made possible by creative and venturesome individuals who were fascinated with novelty and progress. Innovation also drives our future careers and the specialty as a whole. We must foster physician participation in technology discovery in a medical education system that does not always reward creativity or teach innovation. To this end, the SIR Resident, Fellow and Student Section (RFS) is working to establish an IR Innovation Program (IRIP) that, like the AO Foundation–Synthes collaboration, will stimulate physician engagement in medical innovation.


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