by William L. Henrich, MD, MACP
and Pedro L. Delgado, MD
In recent months, conflict of interest
(COI) and conflict of commitment
(COC) have become matters of
public importance for physicians.
Examples of such conflict include writing
prescriptions from drug makers
who have provided gifts or trips for
doctors, or the writing of clinical practice
guidelines favorable to a product
while receiving funds or favors from
the product’s manufacturer.
Institutions around the United
States have struggled to find an appropriate
response to the problem —
seeking a balance between impropriety
and the ordinary commerce important
to bring a product to market.
The University of Texas Health
Science Center at San Antonio will
implement a new set of policies and
procedures aimed at reducing the
influence of the pharmaceutical
industry and device manufacturers on
educational content and clinical decision-making, as well as setting strong
ethical and procedural standards for
interactions between faculty and
industry. These new policies ban our
faculty from accepting gifts (including
pens, pads, and other small gifts) and
meals. The policies also significantly
restrict the presence of industry representatives
in clinical and teaching
areas of the Health Science Center.
Additionally, there will be increased
requirements for disclosure and oversight
and more explicit parameters for
the establishment and management of contracts between faculty and industry.
These new policies and procedures will greatly reduce the
opportunity for conflicts of interest that might adversely
affect our teaching, research, and clinical activities. The policies
will also have an effect on how our faculty participates in
industry-sponsored activities at a national, regional, and local
level. For example, the new policies prohibit our faculty from
giving presentations for which they do not have full intellectual
control over the content, effectively banning promotional
speaking. Depending on the circumstance, our faculty may
not be able to accept free meals at some Society events, if
these meals are linked to a promotional presentation.
We have adopted these new policies to ensure that the
Health Science Center remains an impartial and independent
resource for our community. Physicians, scientists, and academic
health centers have successfully collaborated with
industry to develop and bring to market many new treatments,
tests, and devices. However, the very success of these
endeavors has contributed to many of the concerns that have
recently been leveled at the health care industry, physicians,
and academic medial centers.
As the financial gain associated with the widespread use of
a particular drug or device has increased, so have the financial
stakes associated with the interpretation of the results of
a clinical trial or the opinions expressed by thought leaders
in scientific publications and presentations. These pressures
led industry to become increasingly focused on managing
the information about a treatment in order to maximize the
impact on sales. Thought leaders and “high prescriber” physicians
were actively courted by industry as part of marketing
efforts aimed at increasing sales. These and other practices
aimed at increasing sales led to many egregious examples of
questionable behavior recently documented in the national
news media.
These new policies for our faculty are born out of concern
for the reasons listed above and for the simple fact
that it is the right thing to do. Our policies are very much
in line with those being adopted by other Schools of
Medicine around the country. We hope that these steps
will more clearly articulate our desire to promote and to
model for our students and residents the highest standards
of ethical and professional behavior. More information
about these policies is available through
the School of Medicine office.
William L. Henrich, MD, MACP
Dean, School of Medicine
Vice President for Medical Affairs
Pedro L. Delgado, MD,
Chair, Department of Psychiatry
Associate Dean for Faculty Development
and Professionalism
back to top
