Correction appended
As medical centers and watch dogs increasingly focus on conflicts of interest in academic medicine, Dartmouth Medical School and its affiliates are working to promote the disclosure of connections between professors and the medical industry.
More than 200 students and faculty members at Harvard Medical School have mobilized to fight the influence of industry in the classroom, The New York Times reported on March 2, "embarrassed" by the "F" rating the school received from the American Medical Student Association, an organization that tracks how well institutions oversee the influence of the pharmaceutical industry on their campuses.
DMS also received an "F" rating because it has not responded to the organization's request for policy information, according to the AMSA web site. DMS administrators, however, said they had responded to the survey, and that the school's information has not yet been processed.
About 10 to 20 Dartmouth faculty members currently work with pharmaceutical and medical manufacturing companies, according to DMS neurology professor James Bernat, the director of the clinical ethics program at Dartmouth-Hitchcock Medical Center.
"We've had a process here at the medical center of a gradual distancing of ourselves from the pharmaceutical industry and medical manufacturing companies," Bernat said. "There can be a lot of benefits to these relationships, but the conflicts from these relationships need to be reported, disclosed and the most egregious of these problems need to be stopped."
Dartmouth banned drug company representatives from visiting campus about two years ago, and DHMC's conflict of interest committee is currently working to publicize employees' financial ties to medical and pharmaceutical companies. The committee's policies also apply to DMS faculty members who practice, teach or conduct research at DHMC.
"We are hoping to get to the stage where we can put all this data on a web site," Bernat, a member of the conflict of interest committee, said. "When you publicize it in this way, many people will discontinue their affiliations because it's embarrassing."
Ties between companies and professors can take many forms. Pharmaceutical companies, for example, may pay professors to travel to several hospitals and give lectures to other physicians.
Although the speaker does not necessarily have to mention the company's product, the unspoken agreement often entails that the doctor will mention the drug.
"Those who do it that I know give very good, objective talks," Bernat said. "But I must say, I've been to these talks and I've heard people, not from here, who slanted [the lecture] towards the drug. It takes a person who is a faculty person and makes them an agent of the company."
The American Council on Continuing Education requires that physicians who give lectures to other practicing physicians announce potential conflicts of interest before speaking, according to DMS professor David Nierenberg, who said he does not give such lectures. This policy, however, does not apply to professors or doctors giving lectures to medical students.
"I think that's a good way to handle conflicts of interest," Nierenberg said. "Then the audience knows how to interpret what we say. Something like that is appropriate when talking to medical students. That [makes] them more secure that the material that I'm trying to give to them doesn't have the potential for a hidden conflict of interest in my mind."
Professors may also conduct research funded by pharmaceutical companies, which does not necessarily result in bias, Bernat said.
"There's really no problem with this relationship as long as researchers are given a free hand," Bernat said. "There are now standards for this that offer the researchers certain rights."
Laura Yasaitis '05 DMS '11 said she would be upset if one of their professors had obvious biases because of connections with pharmaceutical companies.
"If they were receiving compensation, I'd be very upset," Yasaitis said. "Every professor presents some sort of bias in how they practice. But if the bias was incorrect or inaccurate, of course I'd be upset."
Bernat said there has been a general increase in interest in disclosure nationwide, noting that a DHMC committee that he chaired 10 years ago attempting to limit the influence of pharmaceutical companies had been unsuccessful.
"[Now] the opinion has changed, and the environment has changed," Bernat said.
The original version of this story stated that DMS had not yet responded to the AMSA's survey, earning it an F rating. In fact, DMS administrators said they have responded to the survey, and the AMSA has yet to process that information.
