AAMC issues guidance on conflict of interest policies

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The Association of American Medical Colleges (AAMC) is urging U.S. teaching hospitals to establish policies that manage financial relationships between physicians and industry so that they do not influence patient care.

A new report, compiled by a task force convened by the AAMC in 2009, offers guidance on how academic medical centers can identify, evaluate and disclose conflicts of interest in clinical care. The 20-member panel was chaired by Patrick J. Brennan, MD, chief medical officer and senior vice president at the University of Pennsylvania Health System in Philadelphia.

In the report, the task force pointed out that partnerships between academic medical centers and industry are “essential to innovation and create powerful collaborations that benefit all patients.” However, the authors noted that the presence of individual or institutional financial interests in these relationships sometimes creates perceived or real conflicts of interests in patient care.

"Because patients and the health of the public are top priorities for the nation's medical schools and teaching hospitals, we must uphold the highest standards of professionalism, while maintaining principled relationships with industry to improve patient care," said AAMC Chief Healthcare Officer Joanne M. Conroy, MD.

Although many academic medical centers have conflicts of interest policies that govern research and corporate relationships, only a small number of these institutions have adopted policies that define and address conflicts of interest in clinical care, according to the association.

To assist in developing guidelines, the report suggested that institutions first evaluate their own compensation systems to determine whether they influence physician behavior and conflict with the best interest of patients.

The report recommended that academic medical centers:
  • Establish mechanisms to identify physician-industry financial relationships and evaluate their potential to bias the clinical decision making of physicians;
  • Consider payments for services, royalties and ownership when assessing individual related financial interests;
  • Set thresholds for physician reporting and institutions' evaluation of reported interests; and
  • Make available to their patients and the public information on the industry relationships of their physicians, their value and efforts to mitigate any bias resulting from these relationships.
The report also urged teaching hospitals to involve patients in helping them to determine what information about physician-industry ties is useful to them and how it should be presented to specific patient groups.

As a follow up to the report, the AAMC is now developing clinical scenarios that can be used by its members to help define their approach to addressing conflicts of interest in patient care.