When the makers of the da Vinci surgical robot asked University of Illinois doctors to appear in a national advertising campaign, their Chicago hospital saw an opportunity to promote its expertise with the device.
But the plan backfired.
Instead of gaining national publicity for being leaders in robotic surgery, the doctors and the University of Illinois Hospital and Health Sciences System are under scrutiny for endorsing a commercial product, a possible violation of U. of I. policy.
The Tribune also found that some doctors pictured in the ad did not initially disclose their financial ties to the company that makes the robot, Intuitive Surgical Inc., as required by the university's policies on conflicts of interest.
Intuitive selected the doctors to observe and monitor use of the device at other hospitals, work for which they were paid. The doctors disclosed that information only after the ad was published and the Tribune requested annual disclosure forms. One surgeon received about $16,000 in the most recent one-year reporting period.
For patients, the doctors' participation in the ad and the lack of transparency raise questions about whether their physicians can offer objective advice when discussing robotic surgery as compared with other options.
"Now that your doctor is a spokesperson for a particular company or a particular product, how do you know that you're going to get advice and recommendations that are really what is best for you?" said Columbia University professor Susan Chimonas, who studies the relationship between physicians and the medical industry.
The full-page ad, which ran in The New York Times Magazine on Jan. 19, shows a dozen U. of I. employees, dressed in white lab coats, with the caption: "We believe in da Vinci Surgery because our patients benefit."
The names of the hospital and the doctors appear in smaller type above the employees.
Intuitive Surgical paid for the advertisement, and U. of I. doctors and the hospital were not compensated for participating, according to the university. A disclaimer in the ad states that the company had paid some doctors for educational services.
U. of I. officials have asked Intuitive Surgical to discontinue the advertisement, and two weeks ago the university launched an investigation into the "circumstances of participation" in the ad. The review is expected to be completed by March 15.
University spokesman Thomas Hardy acknowledged in a statement that the university's participation may have been a mistake. The university is committed to correcting any flaws the review may uncover related to the way it polices conflicts of interest, he said.
"As a large and complex organization that adheres to high standards, the U of I is compelled to tell its public this fact: the University is run by fallible human beings," the statement said. "It is operated by people trying their best. We regret when those efforts fall short."
Though some physicians endorse drugs and medical devices from time to time, it is rare for an entire hospital to put its name behind a specific commercial product, experts said.
"I don't think I've seen anything like it before," Chimonas said. "It is incredible that an entire department is serving as spokespeople for a for-profit company."
Paul Levy, former president and CEO of Beth Israel Deaconess Medical Center in Boston, first drew attention to the ad in his blog, Not Running a Hospital. Among other criticisms, Levy noted that a university administrative staff member, Daniela Nita, appears in the ad wearing a white coat, though she is not a medical worker. The ad also includes six doctors, four nurses and a surgical technician.
The da Vinci robotic system, which allows surgeons to use hand controls to move tiny robotic instruments inside the patient, has gained popularity in recent years as hospitals compete to offer the newest technology.
The company and doctors who use the device say patients benefit through shorter recovery times and hospital stays. Compared with open surgery, patients suffer less blood loss and hospital site infections, according to Intuitive Surgical.
But some advocates and doctors, including the American Congress of Obstetricians and Gynecologists, say claims about the advantages of robotic surgery are not sufficiently founded in controlled, clinical trials.
Last year, a study in the Journal of the American Medical Association found that women who underwent hysterectomies with robotic surgery had similar rates of complications as those who had laparoscopic surgery. Costs for robotic surgery were higher.