From the Editor: He Skillfully Walked the Line

  The healthcare industry, including the world of scientific publications, has changed over my 12 years as Editor of Ostomy Wound Management. When I came on board, what I call the line separating church and state — ie, between providing clinical information versus product promotion — was not as sharp. The journal ran ads for products within articles describing their successful use. Review and disclaimer policies for Editorial Board members were loosely developed. Instructions for authors and accompanying conflict of interest statements were probably half as long as they are now.   Fast forward to 2012 and much higher stakes. Because (published) scientific evidence is increasingly used to develop guidelines of care, the world of healthcare in general, and scientific publications in particular, has seen an embarrassing number of retracted publications and scientific misconduct. To reflect the changing regulatory culture and sustain the integrity of the research published in OWM, we ask reviewers (similar to authors) to provide detailed disclosures and to recuse themselves if any potential conflicts of interest might compromise the impartiality of their comments. But the entire process remains one of individual honesty and responsibility, and we trust that our reviewers, like our authors, will not be cajoled by financial or other incentives at the risk of proliferating substandard information. Still, clinical versus commercial remains a fine line.

  Sadly, we recently lost a clinician and industry icon who finessed walking that line. It wasn’t just his red hair that made you take notice of Robert A. Warriner, III, MD, ABPM/UHM, FACA, FCCP, FCCWS. He had a way of using his wisdom and confidence to make his points without malice and an ability to consolidate church and state into one effort aimed at ensuring patient outcomes are of the utmost importance. You only had to watch him networking at conferences and overhear him in discussion to respect his intelligence, enthusiasm, and dedication to his field of practice.

  Dr. Warriner graduated from Tulane University and Vanderbilt Medical School. After many years in the United States Air Force, he was honorably discharged in 1984 with the rank of Major, and he was a recipient of the Air Force Commendation Medical and Presidential Unit Citation Awards. Originally, he was an anesthesiologist and critical care physician. His interest in hyperbaric medicine was ignited while he was on active duty in the Air Force. In 1990, he became the medical director of the Southeast Texas Center for Wound Care and Hyperbaric Medicine, a facility that provided care for more than 4,000 new patients in 13 years. Dr. Warriner educated physicians and clinicians about hyperbaric oxygen therapy and developed related clinical practice guidelines for chronic wound healing, authoring more than 50 publications related to wound care and hyperbaric medicine. In 2003, Dr. Warriner took his medical expertise to industry, becoming the Chief Medical Officer for Praxis Clinical Services, which later became Diversified Clinical Services and is now Healogics (Jacksonville, FL).

  Dr. Warriner was the recipient of many awards from the Undersea and Hyperbaric Medical Society for contributions to advancing the field of clinical hyperbaric medicine. In addition, in 2008 he received the Lifetime Achievement Award from the World Union of Wound Healing Societies, and in 2009 he was awarded the Sharon Baranoski Founder’s Award, recognizing him as an expert in wound care treatment and disease management.

  Although I cannot ask him personally, I would like to think Dr. Warriner’s career move into industry was based on his believing this was an opportunity to extend his clinical reach and influence. Having the support of a large company allowed him to practice across a much broader population — all at a time when he was waging personal medical battles.

  By making patients and the science behind care his priorities, Dr. Warriner was able to successfully blur the clinical/commercial line for no gain other than to partner clinical experience with industry reach to improve patient care. Just as Robert Frost wrote, “Good fences make good neighbors” in The Mending Wall, the poet countered, “And on a day we meet to walk the line…. there where it is we do not need the wall.” Perhaps with more people like Bob Warriner, the line distinguishing the medical and financial aspects of care could be crossed more often.

This article was not subject to the Ostomy Wound Management peer-review process.