Medical school departments, department
heads often have industry relationships
Study takes first look at
extent of institutional relationships and potential consequences
BOSTON - October 16, 2007 - A study led by members of the
Massachusetts General Hospital Institute
for Health Policy (MGH-IHP) has found that institutional academic-industry
relationships - financial relationships companies have with medical
schools or teaching hospitals rather than with individual physicians
or scientists - are as common and pervasive as individual relationships.
Their report, the first nationwide look at the extent and impact
of these relationships, appears in the Oct. 17 issue of the Journal
of the American Medical Association.
"Our data show that institutional relationships are as ubiquitous
as individual relationships," says Eric Campbell, PhD, of the
MGH-IHP, the study's principal investigator. "As with personal
interactions, some institutional relationships likely pose conflicts
of interest with the overall missions of academic medical centers.
This study is a first step toward compiling information that will
be crucial for the development of policies regarding these relationships."
To investigate the extent of institutional academic-industry relationships,
the researchers conducted a survey of department chairs - senior
members of the academic hierarchy - at 125 U.S. medical schools
and the 15 largest independent teaching hospitals, which conduct
more research than do some medical schools. At each institution
the survey was sent to the chairs of Medicine and Psychiatry - specialties
that often receive industry funding for educational activities -
and two randomly selected chairs of other clinical departments.
Surveys also were sent to the chairs of Microbiology and one randomly
selected non-clinical chair.
The surveys included questions regarding relationships the departments
as administrative units had with pharmaceutical companies and medical
device manufacturers and about any individual relationships involving
the department heads, since those might have an impact on departmental
activities. Respondents were asked about the nature of those relationships
and compensation received - including direct funding, honoraria,
equity or stock options, equipment, royalties and licenses, educational
support, personal gifts, travel expenses and food. They also were
asked whether these relationships had positive or negative effects
on the activities of their own departments and to generally assess
whether particular types of grants or relationships might affect
any department's ability to pursue educational efforts or research
that was independent and unbiased, terms that were emphasized in
the survey itself.
Almost 460 department heads completed and returned the survey, and
their responses indicated that 67 percent of departments and 60
percent of department chairs had some type of industry relationships.
The chairs were most likely to act as consultants, members of a
scientific advisory board or members of speakers bureaus. Non-clinical
departments were most likely to have relationships involving intellectual
property. Relationships between industry and clinical departments
were ubiquitous, with four out of five receiving discretionary funds
for food and beverages, travel and meetings, or research equipment
Relationships involving medical education were quite common, with
65 percent of clinical departments receiving funding for continuing
medical education and 37 percent for resident and fellow training.
More than half the chairs with industry relationships thought they
had a positive effect on their own departments' educational programs.
In their assessment of the impact of industry support on a department's
ability to conduct independent research and education, the chairs
were more concerned about the effect of restricted grants - those
designated for a specific purpose - than unrestricted ones. They
also viewed larger grants as more likely to have negative effects
than smaller gifts. However, the authors point out, other research
has shown that even gifts of little or no monetary value can create
feelings of obligation in recipients.
"We wanted to find when these influential medical leaders thought
relationships with industry might add to or detract from the independence
of medical centers' research and teaching," says Susan Goold,
MHSA, study co-author and bioethicist at the University of Michigan
Medical School. "Although many respondents felt that relationships
with industry could compromise the independence of research or education,
such relationships were nonetheless quite common."
Study co-author Joel S. Weissman, PhD, of the MGH-IHP, adds, "We
surveyed department chairs because they wield considerable influence
over students and the careers of faculty researchers. Given their
seniority, the fact that chairs have relationships with private
industry may not be surprising, but it could be a cause for concern
if there is a negative impact on the conduct of unbiased research
and education that takes place under their watch."
The study was funded by the Greenwall Foundation. Additional co-authors
are Sowmya Rao, PhD, and Sandra Feibelmann, MPH, of the MGH-IHP;
Beverly Moy, MD, MPH, of the MGH Cancer Center; and Susan Ehringhaus,
JD, American Association of Medical Colleges.
Massachusetts General Hospital, established in 1811, is the original
and largest teaching hospital of Harvard Medical School. The MGH
conducts the largest hospital-based research program in the United
States, with an annual research budget of more than $500 million
and major research centers in AIDS, cardiovascular research, cancer,
computational and integrative biology, cutaneous biology, human
genetics, medical imaging, neurodegenerative disorders, regenerative
medicine, systems biology, transplantation biology and photomedicine.
Media Contacts: Sue
McGreevey, MGH Public Affairs
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