• Sustaining Trust: The AAMC Adopts Report of Task Force on Industry Funding of Medical Education
  • July 15, 2008 | Author: Kevin J. Dill
  • Law Firm: Pepper Hamilton LLP - Philadelphia Office
  • On June 19, 2008, the Executive Council of the Association of American Medical Colleges (AAMC) unanimously approved a report recommending that all medical schools and academic medical centers adopt policies to govern the relationship between their academic mission and industry involvement. The “Report of the AAMC Task Force on Industry Funding of Medical Education to the AAMC Executive Council” describes policies and procedures in the areas of education, clinical practice, and research that should be implemented in academic medical settings in order to maintain what the AAMC calls “professional standards.”

    The AAMC, a nonprofit organization founded in 1876, has significant influence over the direction of academic medicine. The AAMC represents all 129 accredited U.S. and 17 accredited Canadian medical schools, nearly 400 major teaching hospitals and health systems, 109,000 faculty members in 94 academic and scientific societies, 68 Department of Veterans Affairs medical centers, and 67,000 medical students and 104,000 resident physicians. The adoption of the report by the Executive Council of the AAMC represents the potential for sweeping change in the relationship between academic medicine and industry.

    In a press release, the AAMC stated, “Mounting scientific evidence indicates that gifts, favors and other marketing activities, both explicit and implicit, prejudice independent judgment in unconscious ways.” The report stresses the importance of policy and procedure for maintaining the appropriate culture for professional medical education and lists concrete steps that academic institutions should take to manage their relationships with industry.

    The report recommends that academic medical institutions adopt the following standards:

    • establish and implement policies that prohibit the acceptance of any gifts from industry
    • centrally manage the distribution of medications, including industry-provided samples
    • restrict pharmaceutical representative’s access to individual physicians and to non-patient-care areas of facilities
    • supervise meetings between students and industry representatives
    • provide a way industry representatives can provide information about products to faculty in structured settings
    • develop audit mechanisms to assure that continuing medical education programs comply with applicable standards
    • discourage faculty members from participating in industry-sponsored speaking bureaus
    • prohibit physicians, trainees and students from allowing their professional presentations to be ghostwritten by any third party
    • develop policies that require personnel to disclose any conflict of interest relevant to purchasing decisions.

    The report also encourages academic institutions to make clear to their faculty, students and staff that the prohibition of certain activities on campus applies to those same activities off campus.

    Academic medicine and industry have a long-standing relationship and the interaction between the two provides many positive benefits. The AAMC is not trying to remove industry support from academic settings entirely; rather it is recommending ways that the relationship should be managed so that the integrity of the academic mission is ensured. “Interactions between industry and academic medicine are vital to public health,” says AAMC President and CEO Darrell G. Kirch, M.D. “But they must be principled partnerships effectively managed to sustain public trust in both partners’ commitment to patient welfare and the improvement of health care.”

    As described in the March issue of Pepper’s Health Care Law Alert, until now, the pharmaceutical and medical device industries have addressed the potential conflicts of interest in their relationships with academic institutions through internal codes of conduct. The PhRMA Code was developed by the national pharmaceutical industry to manage its relationships with professional medicine. Similarly, the AdvaMed Code provides internal guidelines for medical device manufacturers.

    The decision of the AAMC’s Executive Council to unanimously adopt the report indicates that despite industry efforts to self-regulate, the way the pharmaceutical and medical device industries provide support in academic settings may be required to change. After adopting the report, the AAMC urged all of its members to implement policies and procedures consistent with the report’s guidelines by July 1, 2009.

    In the past, the challenge of effectively managing the relationship between academic medicine and industry in a way that best serves the public interest has been determining the appropriate policy measures to implement. The adoption of the report of the AAMC Task Force provides guidelines to follow. The new challenge will be shaping the recommendations of the report for particular settings so that they enhance the quality of medical education and clinical practice rather then stifling vital interaction between students and faculty and the industry that makes the products that provide critical support for their work.

    Care should be taken to make sure that any changes in policy and procedure are supported by appropriate education, as well as compliance monitoring. There is an opportunity to move the relationship between academic medicine and industry to the next level, if policies and procedures are thoughtfully implemented, according to the controlling principle of the report: “[to] appropriately manage the partnership…between academic medical centers and industry…thereby sustaining public trust in the proposition that both partners are fundamentally dedicated to the welfare of patients and the improvement of public health.”