MSU policy to ask docs to disclose pharma, med device payments

December 20, 2010
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Hundreds of doctors in Grand Rapids and thousands across the state who work with the Michigan State University College of Human Medicine may have new rules for accepting compensation from medical companies, including drug makers, in 2011.

A new ethics policy under development at the Michigan State University College of Human Medicine would cover medical students and full-time faculty members as well as physicians who serve as adjunct instructors, said MSU-CHM Professor Tom Tomlinson, director of the Center for Ethics and Humanities in the Life Sciences

While the policy proposal is still under debate, it would require doctors to disclose payments from pharmaceutical and other companies for review by a faculty committee, he said.

Even the use of company-supplied pens, notebooks and other common trinkets could be banned to avoid exposing students to potential bias, Tomlinson said.

“The policy does not prevent people from having a relationship with industry; that’s a really important part of what we do,” said MSU-CHM Dean Dr. Marsha Rappley. “It just lays out guidelines for things that need to be disclosed and care that people need to take to make sure we separate different hats as we wear them.”

The MSU medical school policy comes amid a national debate over the influence that pharmaceutical and medical device companies obtain with doctors, psychologists and other health professionals by paying them for speaking engagements, advising, consulting and research.

Companies are disclosing more information about such deals due to court orders, pressure from Congress and concern from professional organizations, Tomlinson said.

“At the national level, the American Association of Medical Colleges, the Institute of Medicine and a number of professional organizations like the American Medical Association have in recent years been increasingly concerned about the depth of ties between the medical profession and the pharmaceutical and device industry, and the potential for these sometimes very lucrative financial relationships to adversely affect physicians’ scientific judgments,” he said.

ProPublica, an investigative journalism nonprofit organization, recently compiled a database showing pharmaceutical company payments for 2009 and the first part of 2010. The data was gleaned from information posted on the Web by seven of the more 70 drug makers in the U.S. For more information, see “Dollars for Docs” at www.propublica.org

The database revealed the names of 57 people in Kent County who shared in more than $750,000 from the seven companies during the 18-month period. For details, see today’s Focus section.

“The policy will apply to everyone who comes in contact with students and works with students,” Rappley said.

She said the medical school has a roster of about 1,000 Grand Rapids area physicians who supplement the full-time faculty, although “at any point in time,” only “several hundred” are active in instruction. Full-time faculty numbers around 600. The school has campuses in Grand Rapids and East Lansing, and locations in seven Michigan cities where students spend two years in clinical placements.

The policy must be approved by the College Advisory Council, which consists of departmental representatives. Rappley said comments will be accepted through the first part of 2011.

MSU doctors will be able to continue their relationships with pharmaceutical or medical device companies, Rappley said, but will have to be transparent and will not be allowed to lecture to MSU medical students on related topics.

Micki Benz, Saint Mary’s Health Care’s vice president for development and communications, said an ethics policy is “under investigation” by Trinity Health, which owns the 230-bed hospital at 200 Jefferson St. SE.

Melissa Reardon, director of talent acquisition for the Spectrum Health Medical Group, said a physician workgroup is studying the ethics process as it now stands. SHMG has a conflict of interest and additional outside income policies, she said.

Tomlinson said that policy committee members think it is important for medical students to see all MSU-CHM faculty members modeling behavior that eschews conflict of interest, including those who are outside the full-time faculty.

“This is a matter for a lot of discussion, but the decision has been made — if the policy is approved — that it apply to anyone with a CHM appointment,” Tomlinson said.

“These are most often people who are teaching our students, and they are not just teaching medicine. They’re teaching the standards to which the profession should hold itself. We want our students’ mentors and teachers to be people who abide by the policy and set examples for our students.”

Tomlinson said students are taught about the slippery slope that commences with cash from drug manufacturers. Research has shown, he said, that doctors are influenced by such relationships, even though they may not realize it and may vigorously deny it.

“We do teach our students about this issue,” Tomlinson said. “We provide them some of the evidence that relationships with pharmaceutical companies can influence people’s judgment much more than people are ready to acknowledge.

“There is danger posed to the integrity of clinical and scientific judgments as physicians, so they really should think seriously of whether to enter into relationships with pharmaceutical companies, and how to do so in a way to minimize any adverse effects.”

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