Exclusive: Med School moving toward softer reform

An unreleased draft report from U of M Med School Dean Dr. Deborah Powell shows step toward weaker ethics reform at the school.

University of Minnesota Medical School Dean Dr. Deborah Powell is moving the institution toward weaker ethics reform than her own task force previously recommended, an unreleased draft report obtained by The Minnesota Daily indicates. Incorporating some, but not all, aspects of what many viewed as hard-line and progressive recommendations by the schoolâÄôs conflicts of interest task force, PowellâÄôs draft moves the long-coming policy reform in a much softer direction than expected, sources close to the reform said. From the 13-page report filed by the task force in August, Powell has solicited comments from faculty and consolidated the recommendations into a two-page draft, which will be the basis for a final report to the Board of Regents in April, said Academic Health Center spokeswoman Molly Portz. Critics of PowellâÄôs report point to a disconnect between the task forceâÄôs recommendations and the draft, saying the dean has eliminated some of the strongest and boldest recommendations with little to no explanation. Despite a recent announcement from University President Bob Bruininks that she will leave the deanâÄôs post July 1, Powell will remain at the helm of the ethics reform as planned, Portz said. The controversy from PowellâÄôs latest reform proposal is just the most recent example of a tenure at the school that been mired in questions over her position on the board of directors for Pepsi Co. and conflicts of interest concerns. Even the Medical School task forceâÄôs co-chairman, Dr. Leo Furcht, a Powell appointee, was disciplined for severe violations of the UniversityâÄôs conflict of interest policy in 2004 âÄì a fact that was not disclosed to other members of the task force until reported by the Star Tribune late last year. An inquiry panel then stated Furcht âÄúat a minimum should not be allowed to perform the conflict of interest responsibilities of a department head.âÄù A signed letter from Powell accompanied the panelâÄôs findings, according to a copy provided to The Daily. Unexplained changes Key elements of the task forceâÄôs recommendations, believed by some to be among the most needed changes, are notably absent from PowellâÄôs draft, among them a recommendation to sever financial ties between industry and continuing medical education programs. If enacted, that recommendation âÄúwouldâÄôve put Minnesota on the map,âÄù task force member and University journalism professor Gary Schwitzer said. Powell also rejected the task forceâÄôs recommendation to eliminate the level at which Medical School faculty and staff would be required to disclose financial relationships with industry. Powell recommended lowering the schoolâÄôs current $10,000 threshold to $500, while the task force sought to do away with it all together. The task force recommended that faculty fully disclose the source of research funding as well, particularly those with clinical trials funded by industry, something Powell did not include in her recommendations. A semi-closed process Although the task force filed its recommendations to AHC leadership last summer, some members of the task force and faculty at the school contacted by The Daily were unaware the new draft existed. Schwitzer said he felt in the dark, and news of PowellâÄôs draft report âÄúblindsidedâÄù him. PowellâÄôs draft, dated January 2009, has been circulating through the Medical School at the discretion of the department heads who received it. Dr. Aaron Friedman, head of the pediatrics department, sent the draft to his entire department. âÄúI wanted them to review this most recent draft and offer any comments, concerns, or questions,âÄù Friedman said in a statement provided by Portz. Faculty in his department had previously been given the opportunity to comment on earlier drafts of the proposed policy changes. As of late Thursday Portz had not confirmed which department heads had received PowellâÄôs draft report. âÄòThese are certainly weakerâÄô PowellâÄôs recommendations are weaker in many ways compared to those from the conflict of interest task force, Gabriel Silverman, American Medical Student Association Scorecard director said. Still, even PowellâÄôs recommendations are an improvement from the current conflict of interest policies, which earned a âÄòDâÄô from the AMSA Scorecard in June of last year. In an interview with The Daily last month, Silverman said AMSA would commend the school if it enacted the task forceâÄôs recommendations. Now heâÄôs not so sure. âÄúItâÄôs certainly not as strong as the initial recommendations, âÄú he said. âÄúWhether I would call it a strong policy overall IâÄôm not sure.âÄù TheyâÄôre âÄúborderline,âÄù he added. Silverman also pointed to the loss of the provision separating industry ties to continuing medical education at the school as a concern with PowellâÄôs recommendations. The education program is the best way for doctors to stay current on medical advancements, he said, calling it âÄúirresponsibleâÄù to allow that relationship to continue. âÄúIf a doctor in the community can’t go to a prestigious public university like Minnesota for continuing education programs that are free from industry sponsorship, then where can she go?âÄù he asked. Emma L. Carew is a senior staff reporter. Jake Grovum is editor of the projects desk.