If you’ve ever been to a doctor’s office and noticed pens, notepads, mugs, or other items emblazoned with the names of prescription medications, you’ve seen the tip of the iceberg when it comes to relationships between the pharmaceutical industry and the medical community. For years, drug companies have cultivated close relationships with physicians, researchers, academic medical centers, and hospitals by providing everything from small gifts and luncheons to research funding, speaking fees, and even buildings. But these relationships hold the potential for conflicts of interest, and their era is probably coming to an end, according to Eric Campbell, director of research at Massachusetts General Hospital’s Mongan Institute for Health Policy and associate professor of medicine at Harvard Medical School.
Campbell made his remarks at a recent medical education grand rounds held at the University of Connecticut Health Center in Farmington. It was the first in a series of national grand rounds being sponsored by the National Physicians Alliance (NPA). NPA, the American Medical Student Association, Community Catalyst, and the Pew Charitable Trusts have joined forces to form the Partnership to Advance Conflict-free Medical Education.
A health care policy analyst, Campbell aims to help decision-makers in government and the medical community use data – rather than opinions or assumptions – when developing laws and policies. Based on the research data he has assembled, Campbell made several key points about academic-industry relationships (AIRs), which he defined as, “at their heart, an exchange of goods and services between the academic sector and industry.”
The data, Campbell said, show that “Academic-industry relationships are ubiquitous in all parts of medical education, patient care, and medical research today. These relationships have demonstrated benefits and demonstrated risks.”
Studies show that large percentages of medical students, physicians, academic researchers, department chairs, and institutions have some sort of relationship with industry. Concerned about the potential for conflicts of interest, many institutions have already banned faculty from accepting meals, serving on companies’ speakers’ bureaus, and more. Institutions, and even some states, have begun to require public disclosure of all AIRs and have banned certain activities.
UConn’s School of Medicine has in place strong policies and practices regarding academic-industry relationships, says Christine Thatcher, director of medical education. “We are committed to sustaining an environment that promotes the professional development of our students. Eliminating the intrusion of conflicts of interest in clinical, academic, and research activities is integral to cultivating such an environment,” she says.
Through direct educational content and emphasis on institutional policies, the school provides guidance to students in their current roles in classroom, outpatient and inpatient settings and, ultimately, as decision-makers in their professional careers.
“Our goal is to instruct medical students in ethical practices and responsibilities that will guide their relationships with industry throughout their careers,” Thatcher says.
Going forward, Eric Campbell expects to see an increase in institutional and governmental regulation and oversight of AIRs. Institutions are likely to monitor physicians’ prescribing patterns and more closely scrutinize AIRs. Industry-sponsored continuing medical education programs are likely to be phased out. More medical schools and teaching hospitals will ban certain types of AIRs. Companies will no longer be able to use traditional models to market drugs to physicians. And that’s OK with Campbell.
“We should eliminate all marketing relationships from academic medicine,” Campbell said. “I don’t believe academic institutions should be in the business of marketing drugs.”