The good name of Harvard Medical School has been a bit sullied these days. The NY Times details the general ickitude in an article about a couple of bold medical students who came forward with the idea that perhaps it was not right to learn about drugs from people who made money--and one can only assume lots of it--moonlighting as speakers touting the wonders of the very drugs about which they were supposed to teach with disinterest. One choice tidbit: one of the students meekly asked a pharm professor about the side effects of cholesterol drugs, and apparently got "belittled" in reply. A fellow med student named Matt Zerden did some online checking afterward and discovered that said professor was a paid consultant to 10 drug companies, including five makers of cholesterol treatments. Bravo, future Doc Zerden and your fellow activists! The article notes that the American Medical Student Association has given Harvard an "F" for how poorly it monitors and controls the relationship between its faculty and big pharma, though its Ivy-league cousin the University of Pennsylvania got an "A." The silver lining may be that the new dean, Dr. Jeffrey S. Flier, wants to make some changes and has convened a committee to re-examine Harvard's policies. Billy's Blog promises to hope for the best and report on any changes should they become known to him.
Better still is that the Harvard student activists, while holding a demonstration to call attention to the problems inherent in such laissez-faire policies, were photographed by an employee of Pfizer in what appears to be a creepy kind of surveillance project. Senator Charles Grassley (R-Iowa), who is investigating the relationships between the pharmaceutical industry and physicians, is looking into the shenanigans. Go Chuck! (I have delivered my one endorsement for a Republican in the year 2009.)
One last recommendation for the truly interested is to check out the comments section to the main article (on Harvard's ethics issues, the first link above). The "Editor's Selections" include at least two hum-dingers, with a reasoning process that would bring a smile to Rush Limbaugh's face (see comment #11 from RichardN, Idaho, and #16 from Dr. O, Michigan). Apparently the Editors feel a need to represent letters both pro and con, regardless of how well the comments are written. The "Readers Recommendations" I find to be more telling of what a highly literate, sophisticated group like NYT readers think of the comments, and--no surprise, this--the above comments don't arouse much sympathy.
--br
Great issue that the Institution of Harvard University is facing off, we don't know what is really the core of this issue but we all know the credibility of being a Harvard Graduate.
ReplyDeleteI would argue that we actually do know the core of the issue: that there is a faculty conflict-of-interest between their responsibility to educate medical students (on the one hand) and their acceptance of money from pharmaceutical companies (on the other). I grant that the issue has subtleties; a professor engaged in a research study of Drug X who has been given grant money by a pharm company that makes Drug X isn't necessarily unethical or even automatically biased. But the problem is that many, many professors who teach students also serve as "speakers" or "paid consultants" to these companies, sometimes making money far in excess of what they earn as physicians, and that to me is a clear conflict of interest and from my reading of the NYT articles appears to be rampant at Harvard. (And if you think I'm exaggerating this last point, please read either or both of these articles: http://www.slate.com/id/2205215/ and http://www.nytimes.com/2007/03/21/us/21drug.html?_r=1&scp=6&sq=physicians%20speaker's%20fees%20&st=cse.)
ReplyDeleteI agree with you that being a graduate of Harvard Medical School carries great credibility--which is all the more reason why all physicians, not just those from Harvard, should want them to get this right. Part of what goes with the identity of World's Greatest School is the fact that laypeople pay attention when they are in the news. Had the same situation of a bunch of uppity AMSA students challenging the school administration happened at, say, UPenn, I doubt it would have gotten the same play in the New York Times. So Harvard has to be the role-model, else we all look bad as a consequence. They can't screw this up, and I do hope that Dr. Flier understands this.