Healthy Skepticism Library item: 17426

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Singer N
Stanford Medical School to Expand Ethics Rules
The New York Times 2010 Mar 22
http://www.nytimes.com/2010/03/22/health/policy/22docs.html

Full text:

The Stanford University School of Medicine plans on Monday to introduce rules that would prohibit its volunteer teaching staff – called adjunct faculty – from giving paid speeches drafted by the makers of drugs or medical devices.

Stanford already has one of the most comprehensive policies in the country governing the interactions between academic faculty and the medical industry. The policy, enacted in 2006, is intended to limit potential industry influence on day-to-day clinical practice and medical education, according to a Stanford press release.

The policy prohibits faculty members from participating in industry speakers’ bureaus in which drug and medical device makers pay a physician to give company-prepared speeches to doctors about company medical products. It also prohibits Stanford faculty members from accepting free gifts, including drug samples for patients.

And as of Monday, the 660 community physicians who volunteer their time to teach at Stanford will also have to abide by the same policy – or give up their Stanford titles.

“We welcome interactions with industry that are positive and collaborative,” Dr. Philip A. Pizzo, the dean of Stanford medical school, said Saturday in a phone interview. “But where I think the line should not be crossed and where we are not going to allow our full-time or part-time faculty to engage is in marketing.”

Until now, the policy has primarily governed full-time faculty members, who represent the day-to-day face of the medical school. That is because Stanford did not want to restrict the practice or income of unpaid adjunct faculty members, Dr. Pizzo said.

But Stanford decided to rethink its policy last November, he said, after The New York Times published an article about an adjunct faculty member who had earned almost $75,000 in six months last year as a speaker for the drug maker Eli Lilly. Lilly now publishes a quarterly database that lists the fees paid to individual physicians for speaking and consulting work on behalf of the company.

“I never imagined that someone in community practice would be earning as much from an industrial source,” Dr. Pizzo said.

Stanford grew concerned that the school’s reputation might be tarnished because of confusion over academic titles, he said. Members of the public, for example, might not understand the difference between a full professor, who was required to abide by the school policy, and an adjunct professor, who was not required to follow the policy but still carried a Stanford title, he said.

Now, those adjunct faculty members who want to enjoy the benefit of a Stanford title will have to adhere to the same policy on conflicts of interest as regular faculty members do.

Dr. Pizzo predicted that some adjunct faculty who earn substantial sums as industry speakers or who use free drug samples in their practices might choose to separate from Stanford instead.

“I think this is going to be a difficult debate going forward,” he said. “I think this is an individual choice.”

Stanford is not the only university reconsidering how it interacts with the pharmaceutical and health care industries.

In January, after teaching hospitals associated with the Harvard Medical School began prohibiting their staff physicians from participating in drug company speakers’ bureaus, a prominent allergy and asthma specialist named Dr. Lawrence M. DuBuske resigned from his job at the Brigham and Women’s Hospital in Boston, The Boston Globe reported.

Even so, Dr. Pizzo of Stanford said, the leading academic medical centers must set a new standard for engaging the public trust in medicine.

“Witness the gradual deterioration in how physicians have been perceived,” Dr. Pizzo said. “We have to get back on the high road and avoid the negative interactions in which industry engages physicians in marketing products.”