I have had the privilege of chairing the Industry Relations Conflict of Interest Committee at the Indiana University School of Medicine, the medical school
where I work, over the past year. I have learned a lot about interactions of academic physicians with industry, and have
certainly heard differing opinions on the topic. Our policies were recently approved
(unanimously, I might add!) by all of the pertinent committees, and already,
many faculty have had comments and questions about specifics of the policy.
One common theme that we have also heard is that “regulatory
agencies and administrative bodies” have hurt the field of medicine. I certainly understand the additional burdens
of what it takes to practice medicine, and how those burdens can actually damage the patient-physician relationship.
However, when one looks at why conflict of interest policies are put in
place, one needn’t look very far to see why it is necessary.
Here is a prime example.
The Journal of Patient Safety had to deal with this recent example with its own editor. Dr. Charles Denham, the [now] former
editor of the journal, failed to disclose his own financial conflicts of
interest with organizations which paid him. This impacted recommendations he
made with respect to clinical guidelines that center around optimizing patient safety.
What is interesting to me is that sometimes, how one handles a scandal can be as important as the scandal itself. Covering it up, hiding it, or trying to sweep it under the rug are all examples of ways that don’t work. It is amazing that it is this same sense of “doing the right thing” that parents try to teach their children. What impressed me in this example is how the journal chose to address this. The journal has opted to
tighten its own policies and processes around conflict of interest, for
authors, editors and others who make decisions about articles within the
journal. They even published an article
describing what they plan to do.
For anyone wondering how to handle a scandal, THIS is how to
handle a scandal. Admit the wrongdoing,
describe what steps need to be taken for the better, and, simply,
apologize. As written in this NPR piece, “airing the dirty laundry”, while painful, is a necessary step.
I applaud Dr. Albert Wu, Dr. David Bates
and the journal editors for demonstrating the right way to manage this situation. I think this is a great learning experience
for the patient safety movement, for editors, and for all physicians who interact with industry. Conflicts of interest are complex, but it all
comes back to the fact that there is a public trust that must be put front and
center. If we violate that trust, then we have done a disservice to the profession, to ourselves, and, most importantly, to our patients.
