It’s no secret that medical device and pharmaceutical companies have had long-standing relationships with medical schools, teaching hospitals, and their faculty and clinical staff. And although fruitful collaborations with these companies, primarily for research, should continue, some of these relationships have gone too far.
While many schools have significantly strengthened their conflict-of-interest policies that govern these relationships, industry still brings biased information into our nation’s medical schools and teaching hospitals. These institutions are the training grounds for medical education—places that should be steeped in evidence-based clinical care and learning. One recent survey of medical schools, for example, found that up to half of medical students and residents reported receiving personal gifts from pharmaceutical companies, even in schools graded highly on the AMSA Scorecard.
Effective conflict-of-interest policies, guidelines for how industry can (or cannot) interact with an institution, are key to preventing this industry overreach. There is evidence demonstrating that COI policies at medical schools can, in fact, impact prescribing behavior. One study showed that graduates from schools with strong COI policies prescribed antidepressants more rationally than graduates with weaker or no COI policies.
Yesterday the Pew Charitable Trusts, in partnership with an expert task force of leaders from academic medicine and other partners, including Community Catalyst, released a set of 15 best practices for medical schools and teaching hospitals to use in developing conflict-of-interest policies. These experts have set a high standard for schools and teaching hospitals, with recommendations that COI policies should include banning pharmaceutical representatives from any interaction with faculty, students or trainees to ensure affiliate hospitals and clinics are following the same policies. See a shorter version of these best practice recommendations in the December 2013 issue of the Journal of the American Medical Association.
Community Catalyst believes that though these recommendations are strong, they can be attained. To that end, we have created Toolkits to assist academic leaders, faculty and students in working for improvements in their institutions. Toolkits are now available on interactions with sales representatives, receipt of gifts from drug companies, samples, industry support of continuing medical education, promotional speaking, ghostwriting and COI curricula.
Progress is being on many fronts, but setting a high bar for controlling conflicts of interest will help medical institutions play the critical leadership role that patients and students expect.
--Marcia Hams is a member of the Expert Task Force