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To the Editor: In their Special Communication, Dr Rothman and colleagues¹ addressed a challenging and important issue. However, important critical elements of the PMA-industry relationship as it relates to surgical PMAs and the medical device industry were not considered.

We believe that the medical device industry and pharmaceutical industry are significantly different with regard to PMA and industry relationships. The distinction between science and education vs sales and marketing must be emphasized. Device industry involvement in the training of surgeons is vital. We believe that if relationships between the device industry and surgical PMAs were eliminated, medical progress would slow and patients may be harmed.

As the authors noted, industry plays an important role in the development and testing of new instruments and devices. This is particularly important in the field of surgery, where devices can be developed only through partnership with the surgeons who use these devices. The pharmaceutical . . . [Full Text of this Article]

C. Daniel Smith, MD
smith.c.daniel@mayo.edu
Department of Surgery
Mayo Clinic
Jacksonville, Florida

Jo Buyske, MD
American Board of Surgery
Philadelphia, Pennsylvania

Mark A. Talamini, MD
Department of Surgery
University of California, San Diego

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