Academic Medical Centers: Harvard to Revise their Conflict of Interest Policy in Six Weeks

Harvard University is looking at a complete revision their conflict of interest policy over the next four to six weeks.  They have decided that they want to work under short timeframe with no apparent reason other than to appease a group of vocal students.

Throughout the past year, one student group (the American Medical Students Association) at Harvard Medical School (HMS) has been constantly pressing administrators to strengthen existing policies to regulate industry ties at both the school and at its affiliated hospitals.

This issue first became public attention when Senator Charles Grassley (R-IA), reported in June 2008 that psychiatrist Joseph Biederman of Harvard-affiliated Mass. General Hospital received $1.6 million in consulting and speaking fees from the makers of drugs he had used to treat children for bipolar disorder.

As a result of this announcement, a small group of “vocal first-year students” at the Medical School “publicly challenged the Medical School administration” to address this incident in order to prevent issues in the future. 

Consequently, students like David C. Tian began to protest by asserting that the Medical School currently does not standardize or set standards with teachers and doctors who regularly interact with industry. The student movement’s momentum however was impeded when Harvard’s 17 affiliated hospitals and institutes began to reignite years of previous fighting concerning one uniform policy across all the hospitals.

According to The Harvard Crimson, Jeffrey S. Flier, Dean of the Medical School, “told the students that the Medical School’s hands were tied and that new conflict of interest policy would be left up to a larger University review.”  

A few months later, David Korn ’54, the University’s recently-appointed vice provost for research, who is leading the University review, told students that “the University policy would not craft specific policies and that any new code of conduct would have to be created by the Medical School.”

Not too far after Korn’s Comments, Mr. Flier “announced the launch of an internal medical school review of conflict of interest policy, and that the committee drafting the new regulations was to include students.”

HMS Conflict Of Interest Policy Committee

Mark L. Zeidel, chair of the department of medicine at Beth Israel, acknowledged that “the committee has met to tackle policy pertaining to basic research, clinical work, and enforcement.” But Peter K. Sorger ’83, a Systems Biology Professor, predicted that “the new policy will closely align” with a new policy from Partners HealthCare, which owns two of Harvard’s largest affiliated hospitals.”

Students Support of Industry at HMS

In response to AMSA, the Benjamin Rush Society, which met with Flier twice, “issued a petition calling for preservation of industry relations at the medical school.” Seemingly, while AMSA students want to extend a ban on industry to all students, the Benjamin Rush Society “strongly opposes” this proposal.

Six-Week Policy or Rough Draft?

Although AMSA students have not met with any administrators about the policy, I am not sure that AMSA with a distorted anti industry stance would add much to the debate other than the whining we are hearing from them now. Also, students did not give HMS the opportunity to address the issue internally before going public, and now the committee will be more focused on the fact that Harvard failed a conflict of interest grade from AMSA for not submitting a policy.

Interestingly, the ‘prescriptions’ for change that these students wanted are finally going to be answered: In six weeks the recommendations from the Medical School’s 19-member conflict of interest review committee will publish their work-up of assessment and guidelines. However, the policy will not be made public until very late summer or very early fall (reason for lag time unclear).

But wait a second, how anyone come up with a "policy" about something so complex and far-reaching in six weeks — during the summer? It took the Institute of Medicine (IOM) two years to craft their conflict of interest policy, and it turned out to be completely one sided and admitted to a complete absence of research.

What can we expect from six-weeks?

What is more troublesome is that the Harvard Medical School committee consists of many individuals who participated in earlier policies — and the Partners Policy. And since that is the case, are we to expect that committee members are going to craft some new, revolutionary ideas and policies (in six weeks), or that they might just carbon copy the old, dysfunctional policies? It also seems that no effort has been made to solicit input from junior or mid-level faculty.

Americans need to ask themselves this: why is one of America’s leading medical institutions taking six weeks to devise a policy that could impact the health of millions?   

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