Call to Action: Two Parts
Overcoming barriers and creating momentum for change requires leaders in the profession to think differently about conflict of interest. If the medical profession does not act, it will lose its prerogative.
We urge the Association of American Medical Colleges (AAMC) to provide leadership on these issues across all medical schools and teaching hospitals in the United States. The AAMC has convened a task force dedicated to this issue. To fulfill the AAMC mission of “strengthening the quality of medical education and improving the nation's health by enhancing the effectiveness of academic medicine,” the organization must now promote a national agenda and a level playing field.
The AAMC should:
- Exert leadership by strengthening its guidelines related to conflict of interest
- Provide assistance to member AMCs so they can implement effective reforms
- Create an oversight committee to evaluate the actions of member organizations.
While the AAMC needs to provide overall guidance, it will be individual AMCs that determine the ultimate success or failure of efforts to eliminate conflicts of interest. Therefore, we call on all academic medical centers to:
- Examine best practices at other institutions, including those mentioned
- Assess current policies on conflict of interest
- Engage faculty broadly to build commitment at all levels
- Address key issues and announce the new policies to the professional and broader communities
- Enforce adherence through an effective monitoring system.
Conclusion
The medical profession and the public look to AMCs for leadership. New standards must demonstrate the importance of evidence-based practice, free from industry influence and bias. The Prescription Project is assisting AMCs by facilitating communication, providing toolkits and developing concrete and effective best-practice recommendations.
Strong standards will advance patient well-being and free physicians from conflicts of interest. Now is the time for action.
The Prescription Project (RxP), led by Community Catalyst and the Institute on Medicine as a Profession and funded by The Pew Charitable Trusts, seeks to eliminate conflicts of interest created by industry marketing by promoting policy change among academic medical centers, professional medical societies and public and private payers. The Prescription Project has spent the past six months working closely with academic medical centers to investigate their current polices and promote best practices among them.
"The legislation requiring public disclosure of the financial relationships between healthcare vendors and physicians has been widely discussed in policy circles for years. Critics claimed payments for speaking, consulting, research or even the small trinkets and meals delivered during routine sales calls unduly influenced physician choices and inflated healthcare costs. To combat those effects, Congress required public reporting of those payments in a publicly accessible database. The legislation, labeled the Physician Payment Sunshine Act, was included in the 2010 healthcare reform law."
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Prescription project director Danny Carlat identifies issues with the Physician Payments Sunshine Act requiring further clarification and guidance. Addressing those would ensure that manufacturers can appropriately implement the final rule, and enable consumers to benefit from transparency reports published by the Centers for Medicare & Medicaid Services.
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The Pew Charitable Trusts is working to decrease the influence of pharmaceutical marketing on doctors’ practices. With a three-year grant from the Attorney General Consumer and Prescriber Education Grant Program, Pew is collaborating several partners to improve conflict-of-interest policies within the 158 medical schools and 400 major teaching hospitals in the United States.
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The Pew Charitable Trusts appreciates this opportunity to submit comments to CMS's "Information Collection Activities" draft guidance. We suggest that both the research and non-research payment templates be modified in order to make it easier for consumers to identify which drugs, devices, biologicals, or medical supplies are associated with particular transfers of value.
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On Feb. 1, 2013, the Centers for Medicare & Medicaid Services published the final rule guiding implementation of the Physician Payments Sunshine Act, which Congress passed as part of the Affordable Care Act in March 2010 to increase transparency in the relationships between physicians and drug and medical device makers. Here are some of the highlights.
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