The author has posted comments on this articleRema Nagarajan, TNN | Apr 3, 2014, 10.06PM IST NEW DELHI: If you thought physicians' conflict of interest was all about freebies, speaking charges or paid holidays doled out by pharma, then check out the latest issue of the Journal of American Medical Association (JAMA). A research letter published in the JAMA has revealed how top leaders in the medical world including medical schools deans, hospitals directors, clinical department chairs and university presidents are on the boards of pharmaceutical companies for which they were paid, on an average, over $300,000 in 2012.

Financial relationships between the pharmaceutical industry and physicians have come under increased scrutiny. Less attention has been paid to relationships between industry and the leadership of academic medical centers (AMCs), who wield considerable influence over research, clinical, and educational missions, said the letter. It revealed that out of 50 companies examined, three lacked publicly available data on governance, but 19 out of the remaining 47 or 40% companies had at least one board member who also held a leadership position at an AMC. According to the letter 18 industry board members held 21 clinical or administrative leadership positions, including 2 university presidents, 6 deans, 6 hospital or health system executive officers, and 7 clinical department chairs or center directors. Forty-one board members held leadership AMC positions in 2012 receiving a mean financial compensation for board membership of $312,564.

"Given the magnitude of competing priorities between academic institutions and pharmaceutical companies, dual leadership roles cannot simply be managed by internal disclosure. These relationships present potentially far-reaching consequences beyond those created when individual physicians consult with industry or receive gifts," stated the letter written by lead author Timothy Anderson of the Department of Internal Medicine, University of Pittsburgh Medical Center along with three others including two from Center for Health Equity Research and Promotion in Pittsburg.

Physicians and medical ethics experts have expressed concern about such lucrative ties with pharma which ought not to be done by university leaders who oversee independent research and the instruction of medical practitioners. Paul Levy, the former president and CEO of Beth Israel Deaconess Medical Centre in Boston, affiliated to Harvard University said in his blog on the issue: "You cannot serve two masters, even if you are highly intelligent. In fact, if you are highly intelligent, you will rationalise the problems away by saying that you cannot be personally corrupted." He added that unlike faculty or staff, top leaders of academic medical institutions were involved in business decisions and corporate partnerships.

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Medical school bosses on boards of pharma companies