A Medical School Looks To Ban Speaking Fees

The move comes a few months after the school received a positive, but qualified grade on the most recent American Medical Student Association annual report card that tracks medical school policies toward financial dealings with the pharmaceutical industry. The AMSA noted that the OHSU med school policy is deficient by failing to prohibit participation in speakers bureaus (see this).

"I think there's a conflict-of-interest potential there that we should just eliminate, so nobody has to think about it," OHSU School of Medicine dean Mark Richardson, who asked an advisory committee to examine the issue last spring, tells the paper. Some staff make upwards of $50,000 annually as members of speakers bureaus, the paper notes.

The decision reflects a growing willingness among medical schools to distance their institutions from policies that may unduly influence medical education, research and practice. Over the past couple of years, various medical schools have tightened or adopted policies to limit industry influence or the perception of conflicts of interest.

Last March, the AMSA issued its most recent scorecard and found that 102 medical schools out of a total of 152 – or 67 percent – were given a grade of A or B for policies governing interactions between drugmakers, faculty and students. And of the 152 medical schools tracked, 17 have policies restricting speaker bureau fees (back story).

The issue has taken on greater urgency as the Sunshine provision of the Affordable Care Act goes into effect next year. The law requires drugmakers to post payments exceeding $10 to physicians on their web sites, among other things. However, the federal government has not yet issued a final rule for gathering and publishing the data.

At OSHU, the new proposal is meeting with mixed reactions. For instance, Susan Tolle, director of the Center for Ethics in Health Care at the university, applauded the move. "The students are right about speakers' bureaus," she tells The Oregonian. "I would like us to live up to that standard." But assistant professor of medicine Pritham Raj disagrees.

That saddens me," he tells the paper, adding that if qualified OHSU faculty members do not educate other healthcare providers, less-qualified doctors will. "I give a lot of lectures. I educate my peers. That's what I love to do and I think there's no greater honor," he says. "I'm not trying to bamboozle anybody."

Similarly OHSU lung cancer specialists Alan Sandler maintains that his integrity was compromised by accepting speaker fees, but that the goal was education. "There is a crying need to get information out to doctors," he tells the paper.

Both physicians earned sizeable speaking fees from drugmakers over the past two years. Sandler received more than $88,000 from Eli Lilly and GlaxoSmithKline for speaking engagements in 2010 and early 2011, the ProPublica database shows (look here). And Raj received more than $105,000 from AstraZeneca during 2010 and early 2011, (see this).

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