A recent article in the New York Times tried to explain new policies (adpoted this past summer) affecting board membership restrictions for doctors. According to the article, Partners HealthCare, located in Boston Massachusetts, which owns two research hospitals affiliated with the Harvard Medical School, “has imposed restrictions on outside pay for two dozen senior officials who also sit on the boards of pharmaceutical or biotechnology companies.” The new rules became effective on January 1, 2010, and “impose limits specifically on outside directors who guide some of the nation’s biggest companies.”
The rules apply to senior officials at the two hospitals, Massachusetts General and Brigham and Women’s Hospitals in
The new rules in effect “also forbid “speaker’s fees from drug companies for any employee, including nearly 8,000 with Harvard faculty appointments.”
Dr. Eugene Braunwald, a Harvard professor and former Partners chief academic officer who was chairman of the policy-writing group, noted that the new policy aims to keep institutional officials on boards, but without personally ‘enriching’ them.
One senior official affected by this policy is Dr. Dennis A. Ausiello, chief of medicine since 1996 at Massachusetts General and the Partners chief scientific officer, who serves on Pfizer’s board. Although he was paid $220,000 in that role, he noted that Pfizer and “other companies were crucial to translate academic research into drugs that benefit patients.” Moreover, his role in both capacities is crucial because “he has oversight of a research, ventures and licensing office that seeks to commercialize the hospitals’ intellectual property,” thus bringing more breakthroughs into practice.
As is the case for many doctors who also serve on corporate boards, Dr. Ausiello is “very proud of his board work,” and does not participate on the board just “to make money.” Instead, he strongly believes that doctors serving in such capacities should “be compensated fairly and symmetrically with fellow board members.”
Supporters of the new policy such as Dr. Arnold S. Relman, former editor of The New England Journal of Medicine, Harvard professor emeritus who regularly opines about conflicts of interest, believes that academic institutions are gong to “lose the confidence of the country and the government,” if such policies are not enforced.
The article then goes on to quote more proponents (but no opponents) of the new policy, and tries to highlight the fact that many successful physicians within Partners also went on to corporate boards.
It is hard to imagine the difference between severing on a corporate board by Harvard economics professors or in government is different than a medical school professor serving on a board?
While some experts believe these conflict-of-interest rules “go further than those of any other academic medical center in restricting outside pay from drug companies,” these experts forget that there is much benefit for patients, companies, universities and hospitals for academic clinicians to be on the boards of pharma and device companies. In fact, “no other academic medical centers have so restricted participation in boards of directors.”
As a result, this new policy overshadows the fact that corporate board membership by hospital based academic clinicians also:
– Give the companies the perspective on what is going on in the real world and understanding of academic research process;
– Give universities a better understanding of the pressures and transparency that corporations face;
– Helps patients in knowing that companies may be dissuaded on a board level from pursuing products and practices that may in the end be counterproductive; and
– Helps patients in that someone on the board is seeing them on a regular basis and can give their perspective as to what is important, can spur pursuing drugs and products that are important vs. what companies may think are important;
What this article also makes no mention of is any particular damages that have arisen from academics serving as paid corporate directors. Instead, the article only focused on comments from supporters of the policy who thought it was timely or even too weak.
The Times piece quotes the Partners policy framer (Eugene Braunwald, MD) as declaring, "The ban on speaking fees was one reason Partners wanted to take a strong stand on the issue of directors." "It would seem unfair to restrict outside pay of junior faculty but not of senior leaders." The framer also is quoted, following a listing of officials with highly remunerative directorships as saying, "what was OK three years ago is not OK now."
It seams disingenuous that was OK three years ago is wrong today. What is right and wrong should not be decided absent of evidence of wrong doing by board members, or based on public and private opinions.
Eventually what will happen with this policy is that Partners will simply demand and receive higher remuneration to compensate for their financial sacrifices based on this regulation.
These officials already receive orders of magnitude greater and more secure salaries than mist junior faculty, and none of the officials offered to give back the money they had received from their directorships.
Ultimately, using academia to gain a better understanding of the process of drug development and commercialization that companies go through will allow industry and academic medical centers to continue to see great advances in medicine. Until evidence shows specific damage done by academics serving as paid corporate directors, these policies should be reconsidered.