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Jumping on the Conflict of Interest Bandwagon

After the Cleveland Clinic announced last week that it would disclose all of its physician's financial relationships with pharmaceutical companies, other hospitals are following suit as not to be left behind on the ethics bandwagon.

Just 2 days after the Clinic's announcement, Penn Medicine has announced that they too will make disclosures. It's a good thing too--leading research that spurred institutions to think differently about gifts, large and small, was none other than Penn's own Arthur Caplan who published the article in the Summer 2003 issue of AJOB.

After doing a little digging, however, I have to say that I hope that other hospitals, large and small, follow the Clinic's lead in publishing disclosures online. Yet, with that said, I hope that they do a better job than the Clinic on the writing and placement of the disclosure.

When I searched for physicians at the Clinic to see if they had any disclosures to make, I found the link below their Biosketch, Education, Specialty Interests, and other relevant characteristics. The very last link on each faculty page is "Industry Relationships". When one clicks on the link a paragraph appears reading:

"Cleveland Clinic physicians and scientists report if they have any collaborations with the pharmaceutical or medical device industries as part of the Cleveland Clinic's procedures. The Cleveland Clinic publicly discloses payments to its physicians and scientists for speaking and consulting of $5,000 or more per year, and any equity, royalties, and fiduciary relationships in companies with which they collaborate. In publicly disclosing this information, the Cleveland Clinic tries to provide information as accurately as possible about its doctors' connections with industry and those of their immediate family members. As of Date X, Dr. Y has reported no financial relationship with industry that is applicable to this listing. Patients should feel free to contact their doctor about relationships with industry and how the relationships are overseen by the Cleveland Clinic. To learn more about the Cleveland Clinic's policies on collaborations with industry and innovation management, go to our Integrity in Innovation page."

As the last link on each page, this ensures that the disclosure statement appears at the very bottom of each faculty page. Could patients miss this information when learning about their clinician? Easily.

And, could this language be a little more user-friendly? Of course. The paragraph is written at a 12th grade level on the Flesh-Kincaid scale (as high as the scale goes) and has a reading ease of 16.6. Informed consent forms are ideally written at a 6th-8th grade level--so shouldn't this disclosure also be written so the majority of inquiring patients will be able to read it?

I don't want to be an enemy of the good in favor of the perfect, but some constructive criticism never hurt anyone. Moreover, as Penn and other academic medical centers jump on this bandwagon, maybe there is more to think about than simply making the disclosure. Making it well is just as important.

Summer Johnson, PhD