Harvard-Affiliated Teaching Hospitals Impose Caps on Outside Pay

Two major Harvard-affiliated teaching hospitals implemented caps on outside pay for senior officials who also sit on boards of pharmaceutical or medical device-making firms effective Jan. 1.

Medical experts have hailed the revised policy at Partners Healthcare—which owns Harvard-affiliates Mass. General and Brigham and Women's Hospitals—as one of the most stringent caps on pharmaceutical companies. The policy, initially released last April, comes as medical school faculty ties to industry have faced national scrutiny and growing criticism in the past couple of years.

Under the revised policy, senior officials at Partners Healthcare hospitals must limit compensation while serving as outside directors of pharmaceutical companies to no more than $5,000 a day. The policy also bans faculty—some who had been receiving more than $200,000 annually—from receiving stock options and accepting speaking engagements.

Partners implemented part of the revised policy in early October, according to Harvard Medical School professor Thomas P. Stossel, who has written extensively about the benefits of industry ties to medicine.

Stossel said that several departments at the two hospitals had brought in lawyers to explain the new Partners policy—as well as the Massachusetts state law passed in Aug. 2008 requiring pharmaceutical and medical device-making firms to publicly disclose gifts worth more than $50.

Following implementation of the new regulations, Stossel said, there has been "some outcry” but no "unified movement" from the near 8,000 physicians affiliated with Harvard.

“There has been no concerted effort on the part of the faculty to turn this around, and there is no evidence that the administration would respond to that,” he said.

“It is a serious case of taxation without representation,” Stossel added.

Others who denounce industry in medicine—like former New England Journal of Medicine editor Arnold S. Relman—have said that these restrictions are long overdue and do not go far enough.

“Transparency and disclosure helps, but it isn’t sufficient,” Relman said in June.

Harvard Medical School embarked on a review of its own conflict of interest policy in Jan. 2009 in conjunction with Harvard’s ongoing efforts to develop University-wide recommendations and guidelines. The school plans to release revised regulations later this year.

The move followed reports in June 2008 from Senator Charles E. Grassley, an Iowa Republican and the ranking member of the Senate Finance Committee, that psychiatrist Joseph Biederman of Harvard-affiliated Mass. General Hospital received $1.6 million in consulting and speaking fees from the makers of drugs that he used to treat children for bipolar disorders

At the Medical School, students have been pushing for more comprehensive disclosure policies across the school and its affiliated hospitals. The teaching hospitals are independent and operate under their own charters, and each has its own conflict of interest policies.

—Barbara B. Depena contributed to the reporting of this story.

—Staff writer Laura G. Mirviss can be reached at lmirviss@fas.harvard.edu.

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