Med. school seeks more transparency

In light of national criticism facing Harvard Medical School, three first-year Yale medical school students are organizing a campuswide effort to minimize pharmaceutical companies’ influence on education.

Iowa Sen. Charles Grassley is currently probing the details of three Harvard psychiatrists who did not properly report receiving at least $4.2 million from Pfizer Pharmaceuticals between 2000 and 2007, while concurrently promoting antipsychotic medicines for children, The New York Times reported Tuesday. The senator is asking Pfizer for information about payments made to at least 149 faculty members at Harvard Medical School, according to the Times.

In a national survey of medical schools administered by the American Medical Students Association last year, Harvard Medical School received an “F” grade on how well it controls the pharmaceutical industry’s payments to faculty. Over the past two years, Yale’s rating on the same survey has dropped from an “A” to a “C.”

By noon today, the three Yale student organizers will send an e-mail calling for Yale medical school administrators to adopt stricter guidelines about faculty members’ drug industry ties. In an earlier e-mail sent to Yale medical students Wednesday, the group said it hopes administrators will realize the importance of making the school’s guidelines on conflicts of interest technically binding, as well as of the need for full disclosure of all teaching faculty’s ties to the drug industry.

At present, the medical school has two policies governing conflicts of interest. The first mandates the full disclosure of drug companies’ sponsorship of and involvement with faculty research. The second — the subject of the current contention — encourages, but does not require, faculty members to disclose all payments received from drug companies.

Yale received a PharmFree rating of “C” because this latter policy is not mandatory and the school does not police the issue, Yale School of Medicine Dean Robert Alpern said.

“We have to trust the faculty because we only know what they tell us,” he said. “There is no other way for us to know.”

(Ironically, when the rating system was first instituted, Yale received an “A” because it was the first school to have a policy governing non-research industry payments to faculty, he said.)

While medical students feel changes to the system are necessary, there are some indications that it has already changed: Over the past five years, drug companies’ presence at the school has diminished considerably, Alpern said. For instance, the medical school limits the number of venues on campus where pharmaceutical representatives can host presentations. It also pays for any talks pharmaceutical representatives give on campus.

Still, the Yale chapter of Universities Allied for Essential Medicines, an international student-led nonprofit organization, believes Yale needs an explicit policy mandating full disclosure of all faculty members’ drug industry ties.

“It is important to make the distinction between scientific agendas and policy agendas,” Sara Crager MED ’12, a joint M.D./doctoral candidate, said.

The drug industry’s desire to fund research will not likely change and is in many ways constructive, Alpern said.

“Interactions between the pharmaceutical industry and academia are important — that’s how we advance health care,” he said. “On the other hand, we have to be very careful. When physicians start selling their souls for money, they start doing things that are not in the best interest of their profession. A few bad apples give the medical profession a bad name.”

Yale’s West Campus will provide an opportunity for the University to foster research and develop important connections with pharmaceutical companies on a larger scale than was previously possible, Vice Rresident for West Campus Planning and Development Michael Donoghue said. Yale is currently engaged in discussions with pharmaceutical companies about potential partnerships, he added.

“The whole idea is to figure out what the best type of relationship is that will take academic research and translate it into something of industrial significance,” Donoghue said. “It’s worthwhile and ought to be encouraged.”

Harvard officials said 1,600 of the medical school’s 8,900 professors and lecturers reported having a direct or indirect financial interest in a business related to their research or clinical practice, but did not specify details, the Times reported Tuesday.

Comments

  • Anonymous

    I can tell you firsthand that Yale Medical students openly welcome pharm money and influence at our beloved school. Please pay no attention to a few hippies and this news article.

  • Nadim Salomon

    While I am for transparency, I would also suggest that these students get involve in asking Yale not to spend more tuition money on fancy gym and cafeteria which are driving the cost of attendance. Also the students should inform themselves on how their university is paying for teaching at medical schools and certainly they should get outraged by how much time physicians waste on the phone with managed care companies to get approval for medications. Many newspapers and especially the NY Times have written bias editorial comments on the relationship between pharmaceutical companies and physicians without doing serious investigative work. They just pick up the worse case scenario and make up a story. This is an awful way to stimulate healthy policies.

    Nadim Salomon, MD

  • Recent Alum

    Let me get this straight: Harvard Med's grade is an F (F!), Yale's grade is a C, and some students still complain that Yale should do more (even though it is two full letter grades ahead of Harvard Med)? What am I missing?

  • Another recent alum

    @ #3
    Who are you, George W. Bush? A C isn't a great grade, especially when Yale used to be getting A's. Yes, we're better than Harvard but there is still plenty of room for improvement (Penn got an A). And what's the big deal about doctors being more transparent? How is that harmful to them or to the university?

  • med student

    Nadim -

    What makes you believe that the medical students are only capable of taking on one issue at a time? Of course we want a nicer gym and cafeteria; we haven't gotten either, but those would be great changes. We know how our teachers are paid - they aren't! It's a problem, and we're trying to bring attention to it. We know how much time docs waste with managed care - we're advocating for single payer national health insurance so we can get rid of these preposterous money-sucking for-profit care-averse insurance companies. And, on top of all of that work that we're already doing (not to mention trying to study for medical school), we're also trying to keep our teachers honest by getting rid of pharma's influence. Maybe you should spend some more time talking to the medical students and a little less time reading articles in the undergrad newspaper.

  • Current Yale Medical Student

    What people seem to fail to realize here is that AMSA is an powerless organization full of the most liberal, leftist medical students. Stating that AMSA gives us a 'C' is a joke. I am sure that NAMBLA would give us an 'F' and PETA would give us even lower. What is damn sure is that I don't care.

    The greater point is that the rest of the students at the Yale University School of Medicine don't care either. My bet is that their vaguely worded online petition got less than 25% of the medical students to sign it.

    On another note, when you show up as a first year, AMSA gives you free anatomy text books if you sign up (an 80 dollar value). Then they claim to be a powerful voice of medical students. If they didn't give away the free text book no one would join their club. That is the truth.

    Go back to playing hacky sack.

  • "Top 5" Med Student

    See #6's comment and read it over and over until you understand it. AMSA is a joke.

    That said, I'm all for reducing or eliminating PhRMA influence from medical education. Let's just not give AMSA any credit, since it deserves none. Its grading criteria are laughable, at best.

  • Grouse

    Faculty teach the medical students for no compensation. Now the students want to take away the sugar teat of big pharma, which has provided a way to supplement paltry academic salaries. Harumpf.