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Pressure Mounting to Deal with Conflicts of Interests

William Sacks

Vice President, COI Product Management

01257766_WB_CR_HCCS-Blog-Images-1_Pressure Mounting to Deal with Conflicts of Interests

In September 2014 the federal government will make available to the public a database of payments from pharmaceutical companies and medical device manufacturers to physicians, and medical schools. Any exchange of value in excess of $10.00, for consulting, honoraria, to pay for medical education or almost any other purpose, will be available for review and analysis.

As public access to this “Physician Payment Sunshine” database gets closer, many hospitals and physicians have started to seriously consider the impact of this data on public perceptions and institutional reputations. There is little doubt that local media outlets will be all over this data when it becomes available in September, looking for payments to physicians that they can portray as excessive and scandalous.

Knowledgeable insiders will understand the complexities of payments to physicians and academic medical centers for research, consulting, and medical education, but casual observers and the less informed public will be left with the impression that conflicts of interests are rampant.

It is very important that Compliance Officers and COI managers bring senior leadership into the loop on these issues, so that they can be prepared to answer detailed questions from members of the skeptical public and press. Common and appropriate relationships between industry and physicians and their medical centers may be portrayed in a negative light, and the C-Suite should be armed with facts about these relationships, and not just respond with promises to investigate.

This can be accomplished by surveying faculty and physicians to gain a comprehensive understanding of individual relationships and working with their research, intellectual property and CME offices to thoroughly understand institutional relationships and potential conflicts.

Institutions need to have rigorous but easily explained policies and procedures in place to identify and manage real and perceived conflicts. Thought should be given – in advance – to how certain relationships will be explained or discussed. Over the last few months, several medical school deans have been cited for maintaining highly paid positions on pharmaceutical company boards. If an organization is going to allow such relationships, it should have a clear story to tell about how that relationship benefits the institution or the general public, and how the potential conflicts that could accrue from that relationship are being managed.

Relationships between industry and medicine are important, and industry contributes to the academic, research and clinical functions of academic medical centers. Nonetheless, in this new age of total transparency, medical centers and their physicians will have to weigh new factors as they consider which relationships they can proudly continue, and which they will find are not worth the effort to defend.