"Serving Two Masters — Conflicts of Interest in Academic Medicine"

Bernard Lo, M.D. - NEJM, Volume 362:669-671, February 25, 2010 Number 8

"In January 2010, Boston-based Partners HealthCare, which includes some of the nation's leading teaching hospitals, began sharply limiting the amount of compensation institutional officials may receive for serving on boards of directors of biomedical companies or companies that are likely to do business with Partners. Declaring that 'compensation [for board service] should be capped at a level befitting an academic role,' Partners limited payments to USD 5,000 per day for the time spent at board meetings and prohibited equity compensation. Partners officials may donate additional compensation to a charitable organization that is not affiliated with Partners. The Partners conflict-of-interest committee will review all such arrangements. The press reported that several Partners officials have received more than USD 200,000 a year as directors of companies that sell pharmaceutical or medical products — a standard level of compensation for directors. The chair of the committee that recommended the new policies reportedly cited 2009 policy changes that prohibit faculty members from serving on speakers' bureaus of drug companies, suggesting that it would seem unfair to restrict the income of junior faculty in this way while refraining from limiting the outside income of senior officials serving on boards.

Relationships between academia and industry have both benefits and risks. Close collaboration between academia and industry has facilitated the development of many new drugs. This is an area in which key interests may be aligned: the public seeks effective new therapies, academia wishes to translate basic discoveries into treatments, and industry wishes to develop new products. As the Partners policy notes, both academia and industry may benefit when academic leaders serve on company boards. Companies may benefit from the wisdom of senior academic physicians and learn about emerging trends in basic research and health care. Academic leaders may learn innovative approaches to organizing scientific research teams or running large, complex organizations, and their networking with other board members may enhance fund-raising.

However, the mission of academic health centers (AHCs) may diverge from that of for-profit medical companies in important ways (...)."

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