A national survey of department chairs at medical schools and teaching hospitals found that more than half have relationships with industry, including receiving financial support, research equipment and consulting fees. As a result, the authors of the study, which appears in this week’s Journal of the American Medical Association (subscription required), say these arrangements require greater disclosure and supervision.

For instance, 60 percent of department chairs had some form of personal relationship with industry, including having served: as a paid consultant for a company (27 percent); as a member of a scientific advisory board (27 percent); as an officer or executive of a company (7 percent); as a founder of a company (9 percent); as a member of a board of directors (11 percent); and as a paid speaker (14 percent). Clinical chairs were significantly more likely than nonclinical chairs to have served on a speakers’ bureau.

Two-thirds of departments as administrative units had relationships with industry. Clinical departments were significantly more likely than nonclinical departments to receive research equipment (17 percent vs. 10 percent), unrestricted funds (19 percent vs. 3 percent), support for research seminars (36 percent vs. 13 percent), support for residency and fellowship training (37 percent vs. 2 percent), and support for department-administered continuing medical education (65 percent vs. 3 percent).

Why does this matter? As the authors note, “the attitudes and experiences of department chairs are significant because they manage the primary organizational structure of medical schools and teaching hospitals.” They go on to say the problem is similar to conflicts between individual faculty members and industry, but on a broader scale. For instance, when a department chair supervises faculty, who conduct research for companies with which the chair has a personal financial relationship, the arrangement can influence the institution’s “core mission.”

“Failure to address the existence and influence of industry relationships with academic institutions could endanger the trust of the public in U.S. medical schools and teaching hospitals,” the authors conclude.

Eric Campbell of Massachusetts General Hospital in Boston and several colleagues surveyed department chairs of 125 accredited allopathic medical schools and the 15 largest independent teaching hospitals in the US. The survey was administered between February 2006 and October 2006, and a total of 459 of 688 eligible department chairs completed the survey, yielding an overall response rate of 67 percent.

Some of the other findings: Clinical departments were also significantly more likely than nonclinical departments to receive discretionary funds to purchase food and beverages in the department, support for professional meetings, and subscriptions to professional journals. Nonclinical departments were significantly more likely to receive money from licensing of intellectual property developed by researchers in the department.

“The prevalence of these relationships among clinical departments in medical schools (and industry) suggests that departments may rely on such
support. Such reliance, in turn, may influence a department’s willingness to engage in research or educational activities that could be harmful the industry partner,” they write.

More than two-thirds of department chairs perceived that having a relationship with industry had no effect on their professional activities, 72 percent viewed a chair’s engaging in more than one industry-related activity (substantial role in a start-up company, consulting, or serving a company’s board) as having a negative impact on a department’s ability to conduct independent unbiased research.