The Council of Medical Specialty Societies (CMSS) released a code for
medical specialty societies, their members and publications to voluntarily
follow regarding appropriate interactions with for-profit companies in the
health care sector.
CMSS said its “Code for Interactions with Companies” is
designed to ensure that relationships with companies are independent and
transparent, and advance medical care for the benefit of patient care
populations. The code, as published on the CMSS Web site, is more stringent
than the Physician Payment Sunshine Act which was incorporated into the Patient
Protection and Affordable Care Act (PPACA), commonly known as the health care
reform act, which was signed into law by President Obama last month.
According to the CMSS, the code includes core principles and detailed
guidance on implementation. The principles included in the code and guidance
suggestions for each are:
- conflicts of interest: Develop and publicly post policies and
procedures to disclose and manage conflicts of interest among those who
participate in society activities — medical meetings, clinical practice
guidelines, scientific journals;
- financial disclosure: Publicly disclose donations and support
received from for-profit companies in the health sector, and disclose board
members’ financial and uncompensated relationships with companies;
- independent program development: Develop and make publicly available
policies and procedures that ensure that educational programs, advocacy
positions, and research grants are developed independent of industry
- independent leadership: Prohibit society leaders (presidents, CEOs,
and editors-in-chief of society journals) from having direct financial
relationships with relevant for-profit companies in the health care sector.
According to a CMSS press release, it represents 32 medical professional
societies with a collective membership of more than 650,000 U.S. physicians.
“Physicians and patients count on medical societies to be
authoritative, independent voices in science and medicine,” Allen Lichter,
MD, chief executive officer of the American Society of Clinical Oncology, and
chair of the CMSS Task Force on Professionalism and Conflict of Interest,
stated in the press release. “By adopting this code, societies demonstrate
their commitment to the highest level of ethical standards in their activities
and to providing the best possible care for patients and populations.”
The Physician Payments Sunshine Act of 2009, originally introduced by
Sens. Charles Grassley (R-Iowa) and Herb Kohl (D-Wisc.) put the onus of
disclosure on industry, requiring device and biologic makers to report payments
to doctors to the Department of Health and Human Services. That bill was not
passed independently, but included as a provision of the PPACA and is scheduled
to go into effect in March 2013.
“Shedding light on industry payments to physicians would be good
for the system,” Grassley said when introducing the bill to the Senate.
“Transparency fosters accountability, and the public has a right to know
about financial relationships.”
Under the Sunshine Act, manufacturers must disclose any “in
kind” payments made to physicians or teaching hospitals in the form of:
compensation; food, entertainment or gifts; travel; consulting fees; honoraria;
research funding or grants; education or conference funding; stocks or stock
options; ownership or investment interest; royalties or licenses; charitable
contributions; and any other transfer of value as described by the secretary of
the Department of Health and Human Services.
As of press time, 13 medical societies have adopted the CMSS code,
including the American Academy of Family Physicians and the Accreditation
Council for Continuing Medical Education. The full code and the list of signers
who have adopted it thus far are available on the CMSS Web site.
“The private sector plays a central role in developing new
treatments and medical advances, and medical societies collaborate with
industry in many ways that benefit medical practice,” Norman Kahn, MD,
executive vice president and chief executive officer of CMSS, stated in the
release. “We developed this code to ensure that those relationships are
appropriate, and to ensure public confidence in our objectivity and commitment
to high-quality care.”
Creative interactions between members of medical societies and private companies are critical for the development and implementation of novel technologies. Execution of the highest ethical standards in these interactions is essential. The basic principal for the development of standards is the mutual respect of medical societies, their members and private companies. Going through the Code, I would have liked to see more indications of such respect. I believe the main responsibility for excluding conflicts of interests lays not on the professional society, but on a physician, who already has been trained in the topic in his or her medical school and through the licensure/board exams.
— Mark Pitkin, PhD
Research professor of physical medicine and rehabilitation, Tufts University School of Medicine and Practitioner Advisory Council member, O&P Business News
I applaud the formulation, articulation and publication of a code by the
CMSS outlining a guide for health care professionals in their interactions with
for-profit companies in the healthcare sector. Overall, I believe that this is
good. As healthcare professionals and providers we must be accountable to the
public and to ourselves in all our interactions. This responsibility applies to
interactions with patients, colleagues, employers, third-party payers and
for-profit healthcare companies.
The CMSS code as articulated embodies the principles we must embrace and
utilize. Independence and transparency are the foundation. These two standards
will positively guide us in all our interactions – whether it is accepting
sponsorships, contributions, grants, trips or trinkets.
As an orthopedist, I believe that if all orthopedic surgeons had
conducted themselves and their practices according to these principles, we
would not have become embroiled in the Department of Justice mess.
— Ramon L. Jimenez, MD
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