Saturday, September 25, 2010

Is Conflict of Interest Pushback Begining to Happen?

Is it possible that physicians and clinical researchers are beginning to push back against their Conflict of Interest (COI) critics? We'd like to think so.

The proof? The Association of American Medical Colleges (AAMC) and other university associations recently asked the National Institutes of Health to loosen up its proposed financial reporting requirements, which have few exceptions. The AAMC et al essentially said that the NIH’s proposed transparency rules are unnecessarily strict. This new opinion differs from the AAMC’s earlier support.

In its letter to the NIH, the AAMC said:

“There is a paucity of evidence that the disclosure and management of financial conflicts of interest affect objectivity and integrity. In the absence of such evidence, onerous regulations are not only unwarranted, but could create a glut of policies that increase activity without adding protections and at the same time erode the trust between the regulators and those being regulated.”

Let’s look at the numbers. In its letter, and we’re essentially quoting, the AAMC says it represents 150 U.S. and Canadian medical schools; about 400 teaching hospitals and health systems; and 89 academic and scientific societies. That’s 125,000 faculty members and 106,000 resident physicians. And that’s only the AAMC. The Association of American Universities represents 61 research universities.

You get the point. That’s a lot of physicians who have chosen a life of medical research or is the place where they develop their medical training. It’s possible that those physicians raised a concern about what the NIH was proposing – and the AAMC leadership listened. A good example of a group listening to what its constituents want for policy and not letting someone in government dictate their way of life.

And maybe that’s the way this COI crisis will resolve itself. Not in a public forum, for all to hear, but in back rooms, away from glaring eyes and media attention. It happened earlier this summer, if you remember, with the AHA and the ACCME drama.

It’s not how we would like it – the unintended consequence is that the public is not hearing the full-throated discussion, but we also think that not everyone cares about how this "sausage" policy is made, but that these COIs do not harm or cause inappropriate care to be delivered.
But at least, if we're right, physicians on both sides of this issue are talking to one another, thrashing this whole thing out.  The next question is how those talks will impact industry collaboration.

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