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Financial relationships between industry and medical schools, teaching hospitals highly prevalent

The JAMA Network Journals

In a national survey of department chairs at medical schools and teaching hospitals, more than half report relationships with industry, including receiving financial and in-kind support, according to a study in the October 17 issue of JAMA. The authors suggest that these findings underscore the need for the disclosure and management of these relationships.

"Institutional academic-industry relationships (IAIRs) exist when academic institutions, or any of their senior officials, have a financial relationship with or financial interests in a public or private company," the researchers write. "Similar to relationships between individual faculty members and industry, relationships between academic institutions and industry, when they conflict, or have the appearance of conflicting, with the core missions of academic medical centers create an institutional conflict of interest, which exists when a department chair supervises faculty who conduct research for companies with which the chair has a personal financial relationship." There have been calls for the establishment of policies and practices for disclosure, evaluation, and management of IAIRs. No national data exist that describe the extent of IAIRs or that could be used for the development of policy.

Eric G. Campbell, Ph.D., of Massachusetts General Hospital, Boston, and colleagues conducted a study to determine the nature, extent, and consequences of IAIRs by surveying department chairs of 125 accredited allopathic medical schools and the 15 largest independent teaching hospitals in the United States. The survey was administered between February 2006 and October 2006. A total of 459 of 688 eligible department chairs completed the survey, yielding an overall response rate of 67 percent.

The researchers found almost two-thirds (60 percent) of department chairs had some form of personal relationship with industry, including having served: as a paid consultant for a company (27 percent); as a member of a scientific advisory board (27 percent); as an officer or executive of a company (7 percent); as a founder of a company (9 percent); as a member of a board of directors (11 percent); and as a paid speaker (14 percent). Clinical chairs were significantly more likely than nonclinical chairs to have served on a speakers' bureau.

Two-thirds (67 percent) of departments as administrative units had relationships with industry. Clinical departments were significantly more likely than nonclinical departments to receive research equipment (17 percent vs. 10 percent), unrestricted funds (19 percent vs. 3 percent), support for research seminars (36 percent vs. 13 percent), support for residency and fellowship training (37 percent vs. 2 percent), and support for department-administered continuing medical education (65 percent vs. 3 percent).

Clinical departments were also significantly more likely than nonclinical departments to receive discretionary funds to purchase food and beverages in the department, support for professional meetings, and subscriptions to professional journals. Nonclinical departments were significantly more likely to receive money from licensing of intellectual property developed by researchers in the department.

More than two-thirds of department chairs perceived that having a relationship with industry had no effect on their professional activities, 72 percent viewed a chair's engaging in more than one industry-related activity (substantial role in a start-up company, consulting, or serving a company's board) as having a negative impact on a department's ability to conduct independent unbiased research.

"This study presents the first empirical data showing that IAIRs are frequent in medical schools and teaching hospitals and thus deserving of attention. Future research is needed to better understand the impact of IAIRs on the independent unbiased performance of the education and research missions of medical schools, the management and disclosure of these relationships at the institutional level, and the impact of institutional policies. Failure to address the existence and influence of industry relationships with academic institutions could endanger the trust of the public in U.S. medical schools and teaching hospitals," the authors conclude.

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(JAMA. 2007;298(15):1779-1786. Available pre-embargo to the media at www.jamamedia.org)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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