It's well known that there has been an ongoing crackdown on physicians who receive payments from drug companies for lectures about their products and are named authors of ghost-written articles for the same purpose. The latter are most frequently academic physicians seeking to increase their income and also pad their CVs. In response, most medical schools have developed rules prohibiting physician faculty members from accepting such payments and including their names on articles with little or no active participation. Drug companies are also now disclosing publicly the amount of money they pay physicians yearly. As a recent article discloses, however, there is more work to be done (see: Should Academic Physicians Serve on Drug-Company Boards?). Below is an excerpt from it:
A study...in the Journal of the American Medical Association (see: Academic Medical Center Leadership on Pharmaceutical Company Boards of Directors) found that of the 50 largest drug companies in the world, 40 percent have at least one board member who is also a leader in an academic medical center. Among U.S. drug companies included in the study, the percentage was even higher at 94 percent. And the fees that academic medical leaders are collecting for their service are not trivial, averaging over $310,000 per year. Such figures are surprising, given that many medical schools have adopted conflict-of-interest policies that include prohibitions against the participation of faculty members and trainees in promotional speaking, industry sponsorship of continuing medical education, access by pharmaceutical representatives to academic medical centers, and gifts from pharmaceutical representatives of any value, including meals, drug samples, and training fellowships. Corporate promotional events and gifts can increase the rate at which physicians prescribe even drugs that offer no proven advantage. These conflict-of-interest policies recognize that companies can influence physicians even when physicians believe that no such impact exists....
How can academic medical centers that prohibit faculty members and trainees from accepting even an inexpensive pen or notebook from a pharmaceutical company—let alone cash—allow their leaders to serve on the boards of firms that pay them on average over $300,000 per year? Is it reasonable to suppose that, if even a small gift represents an unacceptable conflict of interest, a large payment that substantially exceeds the average annual compensation of a faculty physician might do so, as well? Concerning the JAMA study, it should be noted that not all pharmaceutical company academic board members are practicing physicians. The study’s findings included two university presidents, six medical school deans, six hospital chief-executives, and seven clinical department chairs. However, these facts are far from reassuring. Whether such individuals are actually prescribing drugs themselves or not, they are in a position to influence the decision-making of large numbers of faculty members and trainees.
The additional work that needs to be done relates to the relationships of pharmaceutical companies with medical school deans and hospital executives. One might have thought that during the past several years of faculty crackdowns, deans and executive might have concluded that they themselves might also be part of the problem. However, as noted above, "of the 50 largest drug companies in the world, 40 percent have at least one board member who is also a leader in an academic medical center." The path forward is quite clear. Such leaders of academic medical centers need to totally sever any relationships with drug companies. Whether they see continue to see patients is irrelevant. As noted above, this is less a questions about what prescriptions they might write than about real or perceived conflicts of interest of executives.