This week in Nature is an article about the recent Association of Clinical Researchers and Educators (ACRE) meeting and the organization.
The article outlines that ACRE does not yet specific laws, it says, but rather the climate of distrust it claims tough conflict-of-interest rules create. The notion that a physician is automatically tainted by financial interest in a company is “obnoxious”, says Michael Weber, a cardiologist at the State University of New York Downstate Medical Center in Brooklyn, and a member of ACRE’s steering committee. “Just because something is good for industry doesn’t mean it has to be bad for m everyone else.”
The article points out that there have been abuses in the system, some would argue that those are not unusually for any enterprise including medicine and congress. That the remedy for abuses is applying greater diligence towards the enforcement of existing rules and safeguards. In the article Steve Nissen MD of the Cleveland Clinic observers that “I do not believe that a physician that takes more than a million dollars in money from industry can possibly be objective” this is an interesting observation from a physician that has raised multiple millions from industry for his institution. Dr. Nissen did note that academics and industry need to work together, but firewalls are needed between the two.
Not all instances are so clear-cut, argued some at the ACRE meeting. After Hurricane Ike destroyed the cafeteria and much of the first floor of a University of Texas Medical Branch hospital in Galveston, Avi Markowitz, chief of oncology and hematology, agreed to allow the pharmaceutical industry to provide food for the staff. When hospital officials found out, Markowitz says, they told him to stop, as it contravened university policy. “They had no problem at all letting the students, the trainees and the staff go hungry,” he says.
Markowitz pointed out that restrictive rules won’t stop misconduct. He says the new conflict-of-interest rules are like “cutting off everyone’s hands to prevent stealing”. Rather than focusing on upfront prohibition, Thomas Stossel, MD suggests that institutions should “emphasize valiance and punishment”.