More Guidelines on Pharma – Physician relationships

A recent report issued by the Association of American Medical Colleges (AAMC) urges teaching hospitals to establish policies to manage financial relationships between physicians and the pharmaceutical industry so that they do not influence patient care.

The report entitled, In the Interest of Patients: Recommendations for Physician Financial Relationships and Clinical Decision Making is the work of a task force convened by the AAMC in 2009.  It provides guidance on how academic medical centers can identify, evaluate and disclose conflicts of interest in clinical care. In its favor, the report points out that partnerships between academic medical centers and industry are essential to innovation and create powerful collaborations that benefit all patients. However, it warns that the presence of individual or institutional financial interests in these relationships may create perceived or real conflicts of interests in patient care.

Because patients and the health of the public are top priorities for the nation’s medical schools and teaching hospitals, we must uphold the highest standards of professionalism, while maintaining principled relationships with industry to improve patient care,” said AAMC Chief Health Care Officer Joanne M. Conroy, M.D.

Although many academic medical centers already have conflict of interest (COI) policies that govern research and corporate relationships, only a small number of these institutions have adopted policies that define and address conflicts of interest in clinical care.

To help academic medical centers develop guidelines, the report suggests that institutions first evaluate their own compensation systems to determine whether they influence physician behavior and conflict with the best interest of patients.

The report also recommends that academic medical centers:

  • Establish mechanisms to identify physician-industry financial relationships and evaluate their potential to bias the clinical decision-making of physicians
  • Consider payments for services, royalties, and ownership when assessing individual related financial interests
  • Set thresholds for physician reporting and institutions’ evaluation of reported interests
  • Make available to their patient communities and the public information on the industry relationships of their physicians, their value, and efforts to mitigate any bias resulting from these relationships
  • Involve patients to help them to determine what information about physician-industry ties is useful and how it should be presented to specific patient groups

As a follow up to the report, the AAMC is developing clinical scenarios that can be used by its members to help define their approach to addressing conflicts of interest in patient care.

SRxA’s Word on Health welcomes these guidelines and is pleased to see that we are now talking about “managing relationships” with the pharmaceutical industry rather than banning them altogether.  Placing the onus on physicians rather than putting punitive prohibitions on pharma is probably a win-win for both sides.

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