Cleveland Clinic discloses doctors’ business ties

CLEVELAND (AP) — The Cleveland Clinic has started publicizing the business ties its 1,800 doctors and researchers have with drug companies and device makers in an effort to guard against conflicts of interest.

The move announced Wednesday follows a rising national debate on the issue in recent years.

“It’s become clear from government agencies and from the pharmaceutical and medical device industries that it’s important to our patients that they are aware of collaborations between themselves and industry,” said Guy Chisolm, chairman of the clinic’s conflict of interest committee.

The clinic began posting on its Web site last month the names of its physicians and researchers and the companies or organizations with which they have collaborations. Information includes equity interest in a company, rights to royalties or a consulting relationships that pay more than $5,000 a year.

Joseph Hahn, the clinic’s chief of staff, said he believes the Clinic is the first academic medical center in the nation to put the disclosures on a Web site.

“It’s remarkable that we’ve had virtually no resistance,” Chisolm said. “We’ve had doctors wanting clarification and rationale. Supplying this, they’ve immediately gotten on board.”

Chisolm said the postings are not a response to past incidents of possible conflict of interest involving Cleveland Clinic doctors or researchers, but that the hospital was motivated by a growing national trend to reveal possible conflicts.

Sen. Charles Grassley, R-Iowa, is pushing for legislation that requires disclosure of physician payments by drug and medical device manufacturers. Grassley’s bill calls for penalties of $1,000 to $5,000 for failure to report a payment, with an annual cap of $250,000 for knowingly failing to report.

Meanwhile, Eli Lilly and Co. recently announced it will disclose payments of more than $500 to doctors for their roles as advisers and for speaking at educational seminars.

Clinic trustees determined there were shortcomings involving the institution’s conflict of interest disclosures in 2006.

That year, the Clinic removed a nationally prominent doctor from its staff following an internal investigation of his alleged involvement in a conflict of interest. That doctor, Jay Yadav, filed suit against the Clinic about a year ago claiming discrimination and improper handling of his case. That case is still open.

David Rothman, president of Columbia University’s Institute on Medicine as a Profession, questioned whether the Clinic’s $5,000 limit before a disclosure is required might open disclosure to loopholes.

“I’d want to know if a guy is in the pay of seven different companies at the $4,900 level,” he said.

Staff disclosures on its Web site is an important first step, but the Clinic must be even more vigilant, said Dr. Jerome Kassirer, a Stanford University faculty member, former New England Journal of Medicine editor and author of “On the Take,” a book about industry’s influence over doctors.

“There are doctors all over the country who have conflicts of interest and they’ve disclosed them, but that doesn’t necessarily mean that whatever the conflict has caused has gone away,” Kassirer said.

He said internal conflict of issue committees which exist to enforce policies and review potential conflicts generally are composed of peers who are also doctors and researchers.