Friday, February 13, 2009

Med Schools and Drug Money: Who's Keeping Score?

Yesterday I came across a 2008 Scorecard put out by the American Medical Student Association (AMSA), entitled, "Conflict of Interest Policies at Academic Medical Centers." The Scorecard grades (on a scale from A to F) all 151 medical schools in the US based on their policies regarding interactions between medical campuses and pharmaceutical manufacturers and device makers.

Criteria include: Gifts, consulting, speaking, disclosure, samples, purchasing, access, on campus and off-campus education, industry support, curriculum.

Psychiatric education and practice would fall under each med school's policies.

The University of Pittsburgh (whose affiliated Western Psychiatric Institute is a perennial top ten in US News' top psychiatric facilities) leads the pack with "exemplary" policies. For instance, UPMC "has a model consulting policy" designed to foil attempts at bribery disguised as consulting contracts. Each consulting contract "must provide specific tasks and deliverables, with payment commensurate with the tasks assigned."

Seven other medical schools also received top marks.

Recently, two top psychiatry departments were rocked by scandals involving failures by its academic employees to disclose major payments made to them by pharmaceutical companies - Joseph Biederman of Harvard and Charles Nemeroff of Emory University. These two men are the A-Rods of their fields in terms of accomplishments, and, unfortunately, stand to be branded as A-Rods for all the wrong reasons.

Harvard received an F, along with 51 other schools. In no category did its medical school and affiliated institutions receive a passing grade. According to the AMSA, "the medical school itself reported that it currently has no conflict of interest policies corresponding to the Scorecard domains." Nor do its policies specify an oversight mechanism nor are there specific sanctions for noncompliance.

Emory received an "incomplete," with a provisional grade of C. According to the Scorecard, the school "has indicated that its conflict of interest policies are being reviewed and revised at the present time." Thirty-five other schools with policies under review also received incompletes.

What about those two legendary institutions, the Mayo Medical School and Johns Hopkins? Both Ds.

According to the AMSA:

"The public, policymakers and leaders within the medical profession are becoming increasingly worried about financial conflicts of interest influencing medical care and threatening the doctor-patient relationship. Medical schools and academic medical centers can play a powerful leadership role in setting new standards for the profession.

The AMSA through its PharmFree Campaign "continues to advocate for evidence-based rather than marketing-based prescribing practices, global access to essential medicines, and the removal of conflicts of interest."


Anonymous said...

This topic is beginning to really spread across all walks of life. People sense it, but lack the organization and power to band together and make a change. Big money has big power and big influence. When you push against it hard enough, it throws you into the river with cement shoes.

John McManamy said...

Hi, Whybother, absolutely agree. But against big money, we are capable of making small changes, and these small changes can make a helluva difference. Keep pushing ...