Conflicts of interest at UC Denver

Last spring, the administration of the UC Denver Anschutz Medical Campus (AMC) adopted a conflict of interest policy that, among other things, prohibited the acceptance of gifts, promotional materials, meals, travel and other items of value from industrial representatives. It also bans unrestricted grants to individuals as a kind of gift. An FAQ version was produced recently.

The Dean of the medical school sent the following letter to all faculty:

We are entering into the second and last week of voting on our new policy that provides guidelines for our interactions with industry. This comes at a time when the national news media and medical school regulators have their sight squarely focused on this issue. I am concerned that several faculty have told me that while they do see the need for a policy, they found one section of the policy that they disagreed with and so voted against it. Sometimes trying to be perfect is the enemy of being good. Any policy can be modified at any time by the faculty and administration. So if, on balance, you agree that in the current environment, not having a policy is worse than having a good but less than perfect one, I hope you will vote “yes” this week at [deleted].

For those of you who may have been on vacation last week and missed all the discussion, I also want to make sure everyone understands a point I made in last week’s issue of What’s Going On Here. Our school needs to have a new policy for dealing with the acceptance of gifts, meals, speaking fees, cash and other things of value from representatives of drug companies and makers of medical equipment. The Association of American Medical Colleges urged all its members to have such policies by July 2009. The AAMC favors an outright ban on all gifts, meals, etc. The policy we’re now voting on, which is available [URL above], is much more flexible than what the AAMC recommends. It creates no bureaucracy and leaves most decisions to your professional judgment. The UCD SOM needs to be on the right side of this issue.

Last July, the faculty voted to accept the policy, but only by a margin of 420 - 319. The Dean again:

The School of Medicine faculty has approved a new policy regulating interactions with drug company sales staff, suppliers of medical equipment and others with commercial interests in the health care industry. This policy precludes our faculty, fellows, residents, interns, students and staff from accepting gifts, meals, cash and other things of value from industry representatives. It also limits educational funding by commercial companies to unrestricted grants. The policy is designed to maintain objectivity in our teaching and practice of medicine.

The new industry interaction policy attracted more faculty votes than any other policy decision in the medical school’s history. The final margin was 420 for and 319 against. Many of the faculty who voted against the policy emphasized that they understood and supported the need for a policy but voted no because they disagreed with the wording of a particular section or felt that a rewrite might be more parallel to their own particular position. I believe the level of interest and the spirited debate that took place over five months preceding the two-week vote set a healthy precedent for academic discourse and democracy.

We now move to the process of implementing the policy. Today, the executive committee of the medical school discussed forming an operations committee to get the policy up and running. They also suggested that we convene a forum with representatives from industry so as to be better able to mange our relationships in a positive way. I will let you know more when plans formalize.

The new policy envisions significant decision-making power at the levels of department chair, division head, and center and institute director. To that end, we expect to produce some overall guidance documents, including Frequently Asked Questions and perhaps a template letter that can be sent to drug companies, equipment manufacturers and other industry sectors to explain how to fund education through conflicts-free grants.

In order to be accepted by the faculty, many exceptions had to be codified in the document. Please read it careful, paying particular attention to the cited documents and to the exceptions. Then we will discuss the pluses and minuses of this document in class. All will be expected to participate.






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