A process of change is underway in how physicians’ relationships with pharmaceutical and device companies are perceived and in the policy environment governing their interactions. In 2004, a joint task force appointed by the American Board of Internal Medicine Foundation (ABIM) and the Institute on Medicine as a Profession (IMAP) concluded that existing guidelines and policies were inadequate in managing physician-industry relationships and resulting COI. The ABIM-IMAP task force published its policy recommendations on conflict of interest in JAMA in 2006. The proposals stimulated many academic medical centers (AMCs) to evaluate existing guidelines or formulate new ones. In 2008 the Association of American Medical Colleges (AAMC) issued its recommendations on conflict of interest that echoed and reinforced those of the ABIM-IMAP taskforce.
While the larger number of AMCs have still to adopt stringent policies addressing the relationships between their physician faculty and industry, an influential body of prominent medical centers around the country have put into place exemplary COI guidelines and policies. These include at least 25 institutions from both the public and the private sectors and from all regions of the country, including Boston University, University of Massachusetts–Worcester, and Yale University; University of Pennsylvania, University of Pittsburgh; the Universities of Michigan, Wisconsin, and Chicago; and the entire University of California system. These AMCs are joined by such health care delivery organizations as the Henry Ford Health Systems (Detroit), Kaiser Permanente (northern California), and the US Veterans Administration network.
Studies are ongoing to document the process of policy and behavior change at some of these institutions and to compile exemplary practices and policies for dissemination. The following represent IMAP’s recommendations for best practices in specific areas. Complete best practices documents can be found by clicking here.
- Vendor Relations
- Gifts and Meals
- Ghostwriting and Speakers Bureaus
- Drug and Medical Device Procurement
- Continuing Medical Education (CME)