Public perceptions of conflicts of interest

Ethics reform for the Medical School could have been open to public perceptions. In the end, it just didn’t feel that way.

As a longtime health care journalist who now lectures journalists and students about the importance of investigating and writing about conflicts of interest in health care, I was pleased to accept an invitation from the dean of the University of MinnesotaâÄôs Medical School, Deborah Powell , to serve on a task force that would make new COI policy recommendations. In one of the first meetings of the task force, we heard a presentation about the importance of perceptions of conflict of interest âÄî that it is, indeed, even the perception of conflict of interest that must be addressed. Can any of us truly judge how our own actions are perceived by others? How does the public perceive industry funding of continuing medical education? Would the public, if told, wonder why a recommendation to end industry funding of CME was removed from the final report? I was the only true âÄúoutsiderâÄù on this task force, and I donâÄôt know why it was removed. On several occasions, I urged the task force to bring outside parties into the process. What has the Medical School done to gauge public perception of the issues considered by the task force? Since the task force completed its work, I have not heard directly from anyone in the Medical School except for a polite note of thanks from the dean, which promised: âÄúAs we go forward, the Medical School will keep you and other faculty up to date on the progress of new conflict of interest policies.âÄù In my case, at least, that didnâÄôt happen. Instead, local and national reporters started calling, asking if I knew that the man the dean appointed as task force co-chair, Leo Furcht , had, indeed, been disciplined by the dean on COI issues. I had never been told. Journalists wanted my opinion on the circulation of new drafts of the ethics reform report âÄî about which I knew nothing. IâÄôve now learned that some Medical School department heads have questioned, âÄúWhy is this journalism guy commenting on our process?âÄù Perhaps they were never told that their dean invited me. I didnâÄôt ask to be invited, didnâÄôt need the extra work, didnâÄôt really have time for it and didnâÄôt get paid for it. But I attended more task force meetings than some of their Medical School colleagues. (Eight were assigned to my subcommittee. At a couple of subcommittee meetings, I was the only one to show up to meet with the subcommittee chair.) In the end, the conclusion of the task forceâÄôs work felt rushed and incomplete, even after almost a year to make recommendations. I urged the task force and the dean that editorial boards of local news organizations should be shown the draft recommendations, told that this is only a draft and then asked for comment. Perhaps if that had happened, this slow, toxic dribble of news about the process would have been avoided. The process could have been proactive, open to public perceptions, and inviting. The end result just doesnâÄôt feel that way. In the end, the Medical School is correct; it is their report. But at some point theyâÄôre going to have to deal with public perceptions. Gary Schwitzer is an associate professor who teaches health journalism in the School of Journalism and Mass Communication. Please send comments to [email protected]