Sunday, August 16, 2009

Strib Editorial Calls for Leadership and Disclosure at the University of Minnesota

"I think we need to put ourselves in the position of acting according to the highest ethical principles. I believe our people do that now and I believe our people will be doing that in the future as well."
President Bruininks (Daily: 6-18-08)

Iowa started on a conflict-of-interest revamp in January and their policy has recently gone into effect. We are still foot dragging after two years.

And how about the double-dippers, President Bruininks? You do remember them? Or were you hoping that everyone had forgotten about this situation? Last I heard from U of M leadership on the matter was:

"I think people will think what they want to think," Cerra said, in response to possible criticisms of appointing someone who is under investigation. [Daily: 30 July 2008]
Note the date. Cerra is Frank Cerra, our new medical school dean.

And we recently learned of yet another stem cell scandal. The University is being embarrassed at the national level over these matters. Third best what, Dr. Bruininks?

If we do not have integrity at this institution, we have nothing.

Time for a change?

From the Star-Tribune:

[Note added Monday, August 17: As of right now there are a total of 3 comments left on the Strib page for the article below. One of them is mine. The second one is entitled: "Wow! More pharma demonizing" and concludes: "Keep your head up, Dr. Polly." The third comment babbles about: "all the formularies financially pressure the docs to save tens of millions thru the wayward use of generics." Pretty depressing. No wonder we're in the mess we're in. Or maybe everyone is on vacation this month - I don't know.]

U should lead on conflict of interest

Iowa Sen. Chuck Grassley is also pushing for an overdue overhaul on a different medical front: disclosing physicians' lucrative financial ties to industry.

The Iowa Republican sent a stern letter to U President Robert Bruininks ...

The missive opened a window on spine surgeon Dr. David Polly's eyebrow-raising consulting relationship with Medtronic, the Twin Cities-based medical device manufacturer. Among the findings: Polly, a medical school professor, received well over $200,000 a year from the company for four years running.

Safeguards have not kept pace with the proliferation of these consulting arrangements.

"We have not been interested in regulating this; we've been interested in stimulating it,'' said Art Caplan, a well-known University of Pennsylvania medical ethicist. [And former U of M faculty member] "Management of this area has been completely lacking...

Polly's payments illustrate why more oversight is needed locally and federally

Among the most unsettling revelations in Grassley's letter is that U officials did not know how much Polly earned from Medtronic. The current policy, which is under review, only requires Polly and other physicians to report that they have received outside payments of $10,000 or more a year.

Not even the U's own Conflict Review and Management Committee -- which reviewed Polly's ties to Medtronic and recommended a conflict of interest "management plan" for him in 2006 -- knew Polly's total compensation.

How is it possible to assess a conflict of interest, much less manage it, if officials don't know how much money is involved?

The university should have recognized this policy's shortcomings and reacted before receiving Grassley's embarrassing letter.

The University of Minnesota medical school should seize the opportunity provided by Grassley's high-profile letter to not only set its own new standards, but lead the way forward nationally.

It is too late for the University of Minnesota to be a leader in this area. In fact they are being dragged into compliance, kicking and screaming - while trying to make it appear that they welcome change. The evidence of foot dragging is simply overwhelming.

Patton used to say something like: Lead, follow, or get the hell out of the way.

Since Administrative leadership at the University has already declined the first two options, perhaps they should take the third?

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