March 3, 2009 — HMS has long valued faculty collaboration with industry as part of its mission of facilitating scientific discoveries and clinical translation that will benefit the sick and suffering. When Dean Jeffrey S. Flier met with the New York Times reporter, he emphasized that the School is making every effort to ensure that these engagements are governed by its commitment to protect academic independence and to ensure the integrity of the process.
Veracity and integrity are cornerstones of the scientific enterprise at HMS. These core values also map onto the School's educational mission. While HMS policies are designed to ensure that researchers disclose all potential conflicts of interest when publishing papers or presenting at conferences, they also apply to the disclosure of information presented in the classroom. All materials should be presented in a balanced manner, consistent with prevailing evidence, and the School has formalized a requirement that faculty members disclose potential financial conflicts of interest at the beginning of any classroom lectures they deliver.
Recently, Dean Flier received a thoughtful and reflective letter signed by students concerning the NYT article. They wrote, “Our faculty, administration and students operate within an institution that we believe provides superb patient care through innovation, research and integrity.”
They also voiced support for the HMS faculty, “Many of these researchers and physicians have given up potentially lucrative careers in private practice or applied science to work in academia because of their passion to educate future clinicians, often without compensation from the medical school itself. Most work tirelessly to improve patient care, advance their fields and collaborate on new treatment possibilities.”
As the environment in which the School evaluates issues related to conflict of interest steadily evolves, leadership trusts that HMS faculty, who represent many of the world’s leading educators and experts in biomedical research, are committed to producing students who are critical thinkers. The School's goal is to produce leaders of tomorrow who are willing and able to challenge what they are presented, whatever the source.
It’s important to clarify a few specific issues raised in the article. Many HMS staff members have been working closely with the reporter for the past months, ensuring he received accurate and contextualized information. Unfortunately, the article that appeared this week did not reflect the scope of these discussions nor much of the content from the many communications between HMS and the New York Times.
- Dean Flier told the reporter that HMS has a strong COI policy and that, since its inception in 1990, the Faculty of Medicine Policy on Conflicts of Interest and Commitment has included substantial prohibitions regarding faculty research activity when financial interests are involved. Major elements of the policy are in many ways unparalleled and serve as an example for other institutions across the country. The reporter also was updated on HMS’s practice of periodically reviewing the COI policy, most recently in 2003-2004. It was not an accurate reflection of the conversation when the reporter indicated that Dean Flier thought HMS needs to “catch up” to other institutions.
- The article accurately states that last year HMS received $8.6 million in sponsored research grants from industry, and $3 million for support of specific Continuing Medical Education (CME) programs, but it is important to put this information in context. These amounts represent only 3.9% of total HMS (Quad) sponsored-research funding and 13% of all HMS-based CME income. The funding, which went to support the School's research and educational missions, was received pursuant to its conflict of interest policies and consistent with its institutional values.
- The article states that 1,600 of 8,900 professors and lecturers have reported to the dean that they or a family member had a financial interest in a business related to their responsibilities as a faculty member. It is important to note that even the smallest honorarium for a single talk for a single outside organization (including educational and not-for-profit institutions) places a faculty member in this category.
- The reporter included information about the outside activities of former Dean Joseph Martin and Laurie Glimcher, MD. These activities were consistent with the requirements of HMS policy, and the School rejects any implication from this article that their relationships with industry may have been improper.
- Lastly, the article mentions the “F grade” that HMS received from the American Medical Student Association (AMSA). The fact is that AMSA assesses conflict of interest differently from HMS. As a result, the relevance of the AMSA grade is a matter for legitimate discussion.
Taken together, these factors created a narrative that did not accurately reflect the robust history of HMS’s COI policy and the integrity with which HMS pursues its educational and research missions as well as honest and beneficial relationships with industry.
As the HMS Faculty Policy on Conflicts of Interest and Commitment states, “with clear guidelines and principles, in conjunction with appropriate mechanisms for supervision and monitoring, cooperation between industry and academic medicine is consistent with the highest traditions of the medical profession and can energize scientific creativity.” The newly empanelled committee to review the School's policy will determine what changes might be called for to keep the policy at the forefront of this critical area.