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Public perceptions of conflicts of interest

From the Daily:

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

BY Gary Schwitzer PUBLISHED: 02/17/2009

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 Minnesota’s 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 — 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 “outsider” on this task force, and I don’t 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: “As we go forward, the Medical School will keep you and other faculty up to date on the progress of new conflict of interest policies.”

In my case, at least, that didn’t 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 — about which I knew nothing.

I’ve now learned that some Medical School department heads have questioned, “Why is this journalism guy commenting on our process?” Perhaps they were never told that their dean invited me. I didn’t ask to be invited, didn’t need the extra work, didn’t really have time for it and didn’t 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 force’s 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 doesn’t feel that way.

In the end, the Medical School is correct; it is their report. But at some point they’re 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.

I think this serves as an excellent response

to Frank Cerra's Daily piece:

where he claimed:

"Finally, I expected more fairness, more facts and less innuendo from the Daily than the coverage during the past several weeks. It’s unfortunate that this important effort continues to be misrepresented by a few who seem to want to influence the outcome outside of the process."

This whole situation is a disappointment to many of us at the University, both within and outside of the Medical School.

Sincere thanks to Professor Schwitzer for speaking up. I know that this was not easy.

Bill Gleason

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