business

A broad-based conflict-of-interest policy overseeing relationships between the University of Minnesota and the business community has been almost a year in the making, but an end may be in sight.

If implemented, it will make the U one of the few universities in the country to have a conflict policy that covers the entire institution.

In the wake of scandals in which the lines between academic medicine and business have blurred, several medical schools nationwide have adopted ramped-up policies managing potential conflicts of interest. Champions of the policies say that patients and research subjects need to be assured that their caregivers are not tainted by industry influence.

At the U, the process of creating the policy has at times been fraught with controversy and heated debate. While it has progressed in fits and starts, a first set of rules addressing potential conflicts at the Academic Health Center will be implemented later this month, with the universitywide rules to follow later in the year.

The health center policy -- covering the schools of Medicine, Dentistry, Nursing and colleges of Pharmacy and Veterinary Medicine -- is being formalized and will be released this week.

It has been described by officials at the U as far stricter than a policy covering other areas of the university, including the Carlson School of Management. It was generally believed that any school whose work related to medical research or clinical treatment of patients needed heftier ethical boundaries.

"What's interesting about the policy at the University of Minnesota is that it applies to the entire university," said Eric Campbell, an associate professor at Harvard Medical School and prolific researcher on conflict-of-interest issues. "The U of M has the opportunity to be a leader, especially for a public land-grant university."

The relationship between business and academic doctors and researchers has proven to be a hot-button issue in recent years, attracting the interest of members of Congress and others who claim perks such as gifts and meals, consulting contracts and financial support of continuing education courses paid by drug and medical device companies are skewing research and patient care. But little attention has been paid to business' sway in other corners of academia.

Locally there've been concerns about the U's relationship with Medtronic Inc., the nation's largest medical-device company and a longtime partner with the university.

Last year, Sen. Charles Grassley, R-Iowa, launched a probe into the financial ties between Dr. David Polly, a prominent orthopedic surgeon at the medical school, and the Fridley-based medical technology company. Between 2003 and 2007, Medtronic paid Polly $1.2 million for consulting, expenses and honoraria.

The U's proposed policy comes at a time when the nation's top medical schools have adopted tough standards governing these often-controversial relationships.

Last month, Harvard Medical School adopted a new policy that bans faculty from giving promotional talks for drug and medical-device companies, as well as accepting personal gifts, travel and meals. The new rules at Harvard also limit the income faculty can receive from companies for consulting, joining corporate boards and requires disclosure of relationships worth more than $5,000 on a medical school website.

"The reason this issue has gotten so much public attention is that doctors enjoy a very high level of trust from patients and from the public in general," said Tim Anderson, PharmFree Scorecard Director for the American Medical Students' Association, a national organization of physicians-in-training that grades conflict policies. "We worry that business interaction can sway doctors from the best interests of patients."

AMSA's Scorecard acknowledges that the U's policy is a work-in-progress, but had graded the previous medical school policy with a "D."

Origins of the policy

The current policy under review at the U originated more than two years ago with an effort to update the medical schools' conflict-of-interest rules under former Dean Deborah Powell. That process was marred by controversy after it was revealed that the head of the committee writing the rules, Dr. Leo Furcht, was disciplined by the U for his own business dealings.

The medical school's policy eventually morphed into universitywide guidelines, which have been under review by various constituencies since late 2009. General counsel Mark Rotenberg said in an interview that the goal is to finalize and implement the universitywide policy by the end of the year.

"The whole thing has taken longer than we had hoped to implement," Rotenberg said. "That's the result of its complexity and the cutting-edge nature of this policy. We tried to create an administrative policy that is wall-to-wall."

Who and what it covers

The universitywide policy covers all faculty and staff, as well as those employees involved in research activities. It requires all individuals to complete an annual report detailing "significant" financial and business interests related to their university expertise or responsibilities.

A "significant" interest is defined as any payment of $10,000 or more, as well as equity interests in that amount or a stake of 5 percent of more in a company, and royalties for inventions. Executive positions and board memberships must also be disclosed.

Gifts under $25 may be accepted, but ghostwriting --putting one's name on an article when it was written by a business interest -- and payment to promote products or services are banned.

Faculty members are permitted to attend education and training events sponsored by industry, but chancellors, deans and administrative department heads will determine whether payment or reimbursement of expenses associated with the event, including travel, is appropriate.

Business funding for continuing education events is permitted, even in the Academic Health Center, but it must be funneled through a central administrative unit, according to Rotenberg.

The issue of industry funding continuing education events for doctors is a controversial one in medicine. Several medical schools, including the University of Michigan's, have banned it altogether.

Janet Moore • 612-673-7752