University Policies Make Them Easier or Harder?
Earlier this year, we noted that the University of Colorado Medical Campus, National Jewish and Denver Health, were considering “overhauling their conflict of interest policies.” Consequently, the Faculty Senate at the University of Colorado Medical Campus is set to take up this issue very soon.
In a recent commentary in the Denver Post, Thomas P. Stossel, MD, American Cancer Society Professor of Medicine and a director at Harvard Medical School, noted that the impact of this policy “is likely to influence profoundly the future of medical discovery and patient care.”
Dr. Stossel explained how the Faculty Senate is revisiting its so-called "conflict of interest policy" governing its faculty's relationships with industry, a primary engine of medical innovation and medical education. He noted that the outcome will determine whether to make such relationships easier or harder.
First, Dr. Stossel commended CU for “its world-class faculty who provides outstanding patient care, cutting-edge medical innovation and solid education for students and community physicians.” He explained how his wife obtained dental and public health degrees from CU and served on its faculty, and his brother-in-law received life-saving treatment at its hospital; and Dean, Richard Krugman, was also his college classmate.”
Accordingly, he noted his confidence “that CU will take advantage of a unique opportunity to rethink its restrictions on external collaborations, a concept opposed to the very basis of CU's excellence.”
Dr. Stossel noted that since he and Dean Krugman “entered the medical profession over 45 years ago, patient care has improved immensely - almost entirely because of tools and treatments now available to physicians and derived from collaborations between physicians and private industry.” Unfortunately, Dr. Stossel recognized that “a movement spearheaded by a small group of well-connected activists, and abetted by media outlets seeking splashy headlines and by demagogue politicians, coined the pejorative term "conflict of interest" and is dedicated to eliminating or harshly regulating such collaboration.”
He explained how “this movement alleges that physician-industry relationships are corrupt - that they supposedly increase medical costs, bias medical education and alarm the public.” However, these “allegations invert reality.” Dr. Stossel recognized that “medicines account for less than 15 percent of overall health care costs and 70 percent of all prescriptions are for inexpensive generic products. Therefore physicians' prescribing practices have little impact on overall health care expenditures.”
More importantly, Dr. Stossel acknowledged that, “these powerfully useful tools derived from physician-industry relationships do not benefit patients unless physicians prescribe them. Education, irrespective of who pays for it, prolongs and improves quality of life and speculation that "conflict of interest" adversely impacts medical care has no basis in fact.
Unfortunately, Dr. Stossel notes, “physicians' practical preoccupations with caring for their patients, working in their labs and educating colleagues diverted them from focusing on the falsity of the movement's allegations.” As a result, “many medical centers rushed into formulating garbled "conflict of interest" policies that pay lip service to the value of collaboration while limiting or eliminating physicians' freedom of speech, freedom of association and freedom of reward for excellence.”
As Dr. Stossel correctly recognized, “these policies divert precious resources from innovation and education to regulation and compliance. Worse, they are having unintended consequences including documented decreases in medical device development collaborations, with a corresponding decrease in FDA approvals, and reduced commercial support for medical education. Furthermore, the regulations mean fewer community physicians receive education from medical school faculties.”
Consequently, Dr. Stossel notes that CU’s current conflict of interest policy “is better than many - including that of his own medical school,” because “it permits common-sense exceptions to unnecessary prohibitions of valuable activities, such as faculty educating other physicians concerning specific company products.” However, “recent media opportunism, exploited this flexibility to demonize perfectly legitimate industry-derived income of CU faculty members. In response, the CU Faculty Senate is poised to revisit its industry relationship policy.”
Ultimately, Dr. Stossel recognized that “CU now has a unique opportunity to approach industry relationships with the same rigor it applies to the science of medical innovation and education. It can break the imitative defensive reactions attempting to appease politicians and the media (neither of which promote medical innovation) that have caused so many medical institutions to create policies that are harmful to their mission - to advance patient care - and promote rather than strangle its faculty's relationships with industry.” He asserted that “CU owes it to its grateful patients to take such leadership” and the he knows “CU will do the right thing.”