Stanford faculty still taking drug firms' money

Stanford faculty still taking drug firms' money Article:Stanford faculty still taking drug firms' money:/c/a/2010/12/20/MNB51GSBQO.DTLArticle:Stanford faculty still taking drug firms' money:/c/a/2010/12/20/MNB51GSBQO.DTL advertisement|your ad here SFGateHome of the San Francisco Chronicle

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Stanford faculty still taking drug firms' money Tracy Weber,Charles Ornstein, ProPublica

San Francisco Chronicle December 20, 2010 04:00 AM Copyright San Francisco Chronicle. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Monday, December 20, 2010

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As medical schools wrestle with how to keep drug companies from corrupting their faculties, Stanford University is often lauded for its tough stance.

The school was one of the first to stop sales representatives from roaming its halls in 2006. It cut off the flow of free lunches and trinkets emblazoned with drug names. And last year, Stanford banned its physicians from giving paid promotional talks for pharmaceutical companies.

One thing it didn't do was make sure its faculty followed that rule.

A ProPublica investigation found that more than a dozen of the school's doctors were paid speakers in apparent violation of Stanford policy - two of them were paid six figures since last year.

Dr. Philip Pizzo, the dean of Stanford's medical school, sent an e-mail to medical school staff last week calling the conduct "unacceptable." Some doctors' excuses, he wrote, were "difficult if not impossible to reconcile with our policy."

He was not the only school official caught by surprise.

Faculty at a half-dozen other institutions also lectured for drug firms in the last two years despite restrictions on such behavior. The University of Pennsylvania, the University of Pittsburgh and the University of Colorado Denver, among others, have launched reviews.

Conflict-of-interest policies have become increasingly important as academic medical centers worry that promotional talks undermine the credibility not only of the physicians giving them, but also of the institutions they represent. Yet when it comes to enforcing the policies, universities have allowed permissive interpretations and relied on the honor system.

That approach isn't working. Many physicians are in apparent violation, and ignorance or confusion about the rules is widespread.

As a result, some faculty physicians stay on the industry lecture circuit, where they can net tens of thousands of dollars in additional income.

Critics of the practice say delivering talks for drug companies is incompatible with teaching future generations of physicians. That's because drug firms typically pick the topic of the lecture, train the speakers and require them to use company-provided presentation slides.

"You're giving someone else's messages, someone else's talk, someone else's judgments," said Dr. Bernard Lo, a UCSF medical professor who chaired a national panel examining conflicts of interest in medicine. "We don't allow our students to use someone else's work."

Doctors admit errors

Reporters compared the names of faculty members at a dozen medical schools and teaching hospitals with a database of payments reported by seven drug companies. Lists of the physicians whose names matched were provided to the universities and hospitals for verification and comment.

Because the majority of the more than 70 U.S. drug companies don't yet report such payments, the review provides only a glimpse of possible lapses at schools. As more companies make their speaker fees public, additional faculty members probably will show up, several university officials said.

At Stanford, officials said some faculty members provided proof that they had not violated the policy because they used their own lecture materials or stopped speaking as soon as it took effect. Others conceded that they were in the wrong.

Among them was Dr. Alan Yeung, vice chairman of Stanford's department of medicine and chief of cardiovascular medicine, who was paid $53,000 from Eli Lilly & Co. since 2009. In an e-mail, Yeung said he quit speaking for the company this fall.

"I take full responsibility for this error," he said. "Even though I felt that these activities are worthwhile educational endeavors, the perceived monetary conflict may be too great."

Child psychiatrist Hans Steiner was paid $109,000 by Lilly to deliver talks about a drug for attention deficit hyperactivity disorder. In an e-mail, Steiner said he spoke in "very rural and other impoverished settings which only have limited access to experts like me."

He said that he wrongly assumed Stanford's policy didn't apply to him once he became an emeritus professor last year, but that now, "I fully intend to comply."

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Related Topics: Attention-deficit hyperactivity disorder, Professor, University of Colorado Denver, Eli Lilly and Company, Stanford University, University of Pennsylvania, Pharmaceutical industry, University of Pittsburgh, ProPublica

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