Payment data published by ProPublica surrounding industry payments to physicians for educational activities and consulting showed that several faculty members at the Stanford School of Medicine gave paid talks on behalf of drug companies. According to the Stanford Daily, such payments to faculty members “violated University policy and spurred the School of Medicine to decide whether to take disciplinary action.”
In October 2006, the University implemented the Stanford Industry Interactions Policy, which forbids faculty from accepting gifts or compensation from industry and required them to disclose all financial support they received for research or other “continuing medical education.” In 2009, Stanford banned its doctors from giving paid promotional talks for any pharmaceutical company.
Consequently, Stanford School of Medicine Dean Phillip Pizzo condemned the violations revealed by ProPublica in his weekly newsletter to the Stanford medical community” by asserting that such payments are “unacceptable … for anyone with a Stanford title.” Despite the “four to six” faculty members that accepted payments, Dr. Pizzo pointed out that over 1,200 faculty were compliant with the policy. It should be noted that the payments reported by Pro-Publica were all in the transition period to the adoption of Stanford’s restrictive policy, but bureaucrats like Dr. Pizzo rarely ever leave an opportunity to act pompous in front of the media.
In response to Dean Pizzo’s letter, Robert Malenka, professor in psychiatry and behavioral sciences, noted that the “reaction within his circle of colleagues to the policies has been mixed.” Dr. Malenka recognized that “There’s a way of implementing policies where you prevent inappropriate influences of the pharmaceutical industry on clinician decision-making while still facilitating other types of interactions which benefit both academic research centers and the long-term goal of the pharmaceutical companies, which is to make new and better medications.”
Although the newsletter was more concerned with the faculty violations, Dean Pizzo “also cited positive interactions with the industry as integral to the University’s success and credibility as a research institution.” He asserted that Stanford is “eager to support productive and valuable scientific interactions with industry as long as they do not involve marketing, are fully disclosed and adhere to our policies.”
While Dean Pizzo hopes in the future his compliance rate will be almost perfect, he asserted that the School of Medicine will strictly enforce the policy and its addenda to reaffirm the school’s commitment, individually and collectively, to assuring the public trust in their relations with industry. To carry out this mission, he asserted that if violations have occurred, the school “will pursue appropriate disciplinary activity.”
According to the ProPublica story, among Stanford faculty receiving payments was Dr. Alan Yeung, vice chairman of Stanford’s department of medicine and chief of cardiovascular medicine, who was paid $53,000 from Eli Lilly & Co. since 2009. In an e-mail, he explained that although he “felt that these activities are worthwhile educational endeavors, the perceived monetary conflict may be too great.”
Also from Stanford was child psychiatrist Dr. Hans Steiner, who was paid $109,000 by Lilly to deliver talks about a drug for attention deficit hyperactivity disorder. In an e-mail, Steiner said he spoke in “very rural and other impoverished settings which only have limited access to experts like me.” He said that he wrongly assumed Stanford’s policy didn’t apply to him once he became an emeritus professor last year, but that now, “I fully intend to comply.”
Ultimately, policies restricting physicians from engaging in educational activities that are worthwhile and help serve rural and impoverished settings are counterproductive. If a physician cannot continue his experience by collaborating with industry to educate and train others, the quality of care patients receive will decrease.
Eventually, physicians in academia will begin to leave their academic medical centers because of such restrictions, especially given the small income they already earn. If America’s medical schools want to continue the innovation, treatment, and discovery that has helped improve patient outcomes for decades, a middle ground is necessary to balance the goals of industry while preserving the integrity of academia.