Conflict of Interest

Definition

“A conflict of interest is a situation in which financial or other personal considerations have the potential to compromise or bias professional judgment and objectivity.”

From Columbia University’s Conflict of Interest Policy

A Simpler Definition

“Trying to Serve Two Masters”

Lauris C. Kaldjian, MD, PhD

Director, Program in Biomedical Ethics

A Bit of Background

A little38%

A lot1%

None61%

A lot33%

A Little51%

None16%

Perceived Influence of Sales Repson Prescribing Practices

“You” “Other Physicians”

Of Principles and Pens: Attitudes and practices of medicine house stafftoward pharmaceutical promotions Am J Med 2001;110:551

Statements on Conflicts of Interest from: IOM / AAMC /

ABIM

Commonly held belief that small gifts don’t influence behavior is disproved by social science research

C.O.I. is a rampant problem

Disclosure of financial interests is also a myth that incompletely protects patients

Academic Medical Centers must lead the way to abolish gifting practices

JAMA 2006; 295:429-433

S.2029A bill from Senator

Grassley

“...amend Social Security Act to provide transparency in the relationship between physicians and manufacturers of drugs, devices, or medical supplies…”

And increasingly …

We must also address patient/public perceptions that our activities may convey a potential for conflict of interest

Education Domains

UME

GME

CME

Dealing with drug sampling, free meals, etc.

Biopharma support for CME

Clinical Practice

Drug sampling in Clinics

Purchase decision making for medical devices

Device consulting – for development & usage

Research Basic

Clinical

Translational

Entrepreneurial

Completeness of disclosure; is disclosure adequate?

Intellectual property control & patents

Conflict of Interest Task Force

Membership

(N=34)

Broad representation across the College and University

Planned Approach

Inventory & Review Existing Policies (local & national)

Make recommendations with a comprehensive policy (across all 3 core missions)

Timeline

roughly over 1 year

Comments?

Suggestions?

Questions?