Healthy Skepticism Library item: 19146

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Publication type: Journal Article

Chimonas S, Patterson L, Raveis VH, Rothman DJ
Managing Conflicts of Interest in Clinical Care: A National Survey of Policies at U.S. Medical Schools
Acad Med 2011 Jan 18;
http://journals.lww.com/academicmedicine/Abstract/publishahead/Managing_Conflicts_of_Interest_in_Clinical_Care__A.99895.aspx

Abstract:

Dr. Chimonas is associate research
scholar, Center on Medicine as a
Profession, Columbia University, New
York, New York. Ms. Patterson is
research associate, Center on
Medicine as a Profession, Columbia
University, New York, New York. Dr.
Raveis is research professor, School
of Dentistry, New York University,
New York, New York. Dr. Rothman is
professor of social medicine, Center
on Medicine as a Profession,
Columbia University, New York, New
York.

Abstract
PURPOSE: Policy recommendations
specify how academic medical centers
should manage clinical conflicts of
interest (CCOIs), including gifts
and payments to physicians from
pharmaceutical companies. However,
no reliable data exist on the extent
to which schools have policies to
manage CCOIs. The authors sought to
determine the extent and strength of
medical schools’ CCOI policies.

METHOD: A survey asked compliance
officers at 125 MD-granting medical
schools in the United States to
indicate whether their institutions
had policies covering 11 areas of
CCOI and to provide copies of
relevant policies. Policies were
scored as 0 (no policy), 1
(permissive), 2 (moderate), or 3
(stringent), based on published
recommendations. Each school’s
scores were averaged to create a
measure of overall policy strength.
The authors also collected
information on schools’
public/private status, hospital
ownership/affiliation, and NIH
funding to determine whether these
characteristics were associated with
differences in policy strength.

RESULTS: A representative sample of
77 of 125 (62%) medical schools
responded between October 2007 and
December 2008. Absence of policy was
the most frequent finding in 7 of 11
CCOI areas. The mean score for
overall policy strength was 1.2.
Greater NIH funding was associated
with stronger policies in 9 areas.

CONCLUSIONS: This analysis provides
a comprehensive overview of medical
schools’ CCOI policies. Wider
adoption of CCOI policies is crucial
to eliminate undue industry
influence in clinical care and to
preserve public trust in the medical
profession. The authors close with a
consideration of why so few medical
schools have implemented strong
policies.