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Partners' Conflict of Interest Policy's Reach Concerns Docs

Medical School professor David B. Acker, who is also chief of obstetrics at Brigham and Women’s, says he approves of Partners’ new policy, which was released in April 2009 and is now being implemented.

“I can’t comment on how other people viewed this, but to me, it came late,” Acker says. “It has been an obvious problem for some time.”

WALKING THE LINE

But several other employees have raised concerns that its reach may have detrimental effects on physicians’ activities, such as continuing medical education.

Though Medical School professor Charles N. Serhan, who served on the committee that issued the policy recommendations, says he applauds the policy’s aims to rein in conflicts of interest issues, he cautions that its expansive reach does not come without costs.

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“I feel that the pendulum is a little too far in one direction in that our rules are now too tight and could actually stifle innovation,” Serhan says. “With time, it has to come back to some equilibrium.”

Mass. General’s chief surgeon Andrew L. Warshaw acknowledges the necessity of Partners’ policy overhaul but says he is concerned that certain initiatives such as surgical fellowships, which are generally dependent on industry funding, may suffer from the crackdown on outside funding.

“Let’s say that you have a general surgeon who wants to learn minimally invasive techniques, a scenario that is commonly funded by outside interests,” he says. “Is that a bad thing? When someone gets training that they wouldn’t normally get and helps patients?”

Warshaw adds that maintaining the necessary relationship between industry and medicine without distorting physician incentives remains a challenge.

“Society has to make a decision about what skills or new knowledge it wants and values and how it will pay for them, “ he said. “This is the narrow line that we are trying to walk.”

NO MORE TALK

Meanwhile, Barry W. Levine, a clinical professor at the Medical School who has worked at Mass. General for four decades, says he is still figuring out how the new policy will impact his profession.

Levine spoke about lung disease on behalf of drug companies like AstraZeneca and GlaxoSmithKline for about 18 years but says he does not plan to take on any more speaking engagements until the implications of the policy become clearer.

Like Copeland, he says that the new regulations stymie critical education about asthma and emphysema for doctors in underprivileged communities. He routinely meets physicians who do not have access to pulmonary function machines, which are critical for diagnosing these diseases.

“I don’t know why Partners suddenly said this is promoting a drug,” Levine says. “It certainly doesn’t in my mind.”

Moreover, Levine says, the drug companies sponsoring the talks have no power to censor what materials physicians present, as long as the information has been approved by the FDA.

“The drug companies do not tell me what I can say,” he says. “I’ll say what I want.”

—Staff writer Barbara B. Depena Depena can be reached at barbara.b.depena@college.harvard.edu.

—Staff writer Laura G. Mirviss can be reached at lmirviss@fas.harvard.edu.

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