Monday, June 1, 2009

The fish rots from the head: conflicts of interest at Partners and Harvard Medical School

Much has been written about prominent doctors who fail to disclose their lucrative financial ties with pharmaceutical and medical device companies. Yet there has been less focus on hospitals and other leading institutions who have similar conflicts of interest -- until now. In The Boston Globe Sunday, long-time investigative reporter Steve Kurkjian turns the spotlight on the enmeshed relationships between the long-time chairman of Partners, New England largest health-care company, and the pharmaceutical industry.

Kurkjian's eye-opening account reveals that Partners failed to disclose that its long-time chairman, Jack Connors, has owned several lucrative businesses that profited from their close ties both to Partners' teaching hospitals and Harvard Medical School, which provides the faculty and residents that staff Partners hospitals. One of Connors' businesses was a company that received millions of dollars in funding from pharmaceutical companies to provide continuing medical education to doctors affiliated with both Partners and Harvard Medical School. Indeed, as Kurkjian notes, Connors' company, M/C Communications, "profited hugely from an exclusive commercial relationship it maintained with Harvard Medical School." But Partners didn't think it important to disclose that enormous conflict of interest to its own board or the public. Nor did Partners disclose the fact that Connors (after he sold M/C Communications in 2004 for a whopping $450 million) founded another for-profit home-care company that has solicited business from Partners hospitals. If that's not a conflict, I don't know what it is.

Connors, as this fawning 2007 article in The Boston Globe magazine shows, has long been one of Boston's best-connected and wealthiest power brokers. As the founder, long-time executive and now chairman emeritus of Hill Holiday Connors, Cosmopolos, (Partners' advertising firm, by the way) Connors has been at the epicenter of many a lucrative business and political deal in our fair city. For example, back in the '90s, Connors helped engineer a smear campaign against Lois Pines, then running for attorney general against Thomas Reilly. Remember him? {He crashed and burned running for governor of Massachusetts).

A few years back, Connors was even floated as a possible purchaser of The Boston Globe, along with Jack Welch and Mike Barnicle, who was fired by the newspaper for plagiarizing and making stuff up. Can you imagine these three as owners of Boston's paper of record? Perish the thought!

In this case, Connors' undisclosed conflicts of interest are emblematic of the larger flaws that exist in health care today. The kind of profitable and conflicted relationships that he symbolizes go a long way toward explaining why both Partners (which owns Mass. General Hospital) and Harvard Medical School have been so loathe to strengthen their own conflict of interest policies and take action against compromised doctors like Joseph Biederman (a big gun at MGH), despite pressure from students and some faculty. After all, if Partners' own chairman is allowed to get away with undisclosed conflicts of interest, how honest can the folks at the helm of either institution be? Who was it that said the fish rots from the head?

3 comments:

Roy M. Poses MD said...

We noted back in January in Health Care Renewal (http://hcrenewal.blogspot.com/2009/01/to-whom-did-scorpions-in-bottle-owe.html) that Connors had two apparent conflicts that were public, but barely so, and barely discussed. Looks like these may have just been the tip of the iceberg. But maybe that part of the iceberg should have been noticed more.

"Jack Connors, the chair of the board, who is also (http://www.adclub.org/2008_Legends/jack.html) the Chairman Emeritus of marketing communications company Hill, Holliday, Connors, Cosmopoulos Inc, whose clients include pharmaceutical and pharmacy benefits manager CVS / Caremark, and is also a member of the board of directors of Covidien, a medical device company."

Quiact said...

Conflicts of interests are not judged subjectively. They either exist, or they do not. It's a situation in which regard for one duty leads to disregard of another, potentially or actually.

Essentially, in medicine, this is gifting, or the intent of gifting, and will likely affect the reliability of the receiver while providing benefit to the gifter.

As such, the receiver is now conflicted, compromised, and their best judgement is now clouded.

Falsifying clinical research that is entirely premeditated by such criminals, as well as witholding if not destroying negative data that may reflect their product is in fact a panacea screams conflicts of interests.

Why does this progressively occur, this bastardization of the scientific method?

Guidelines, if they exist, are intentionally ignored, as the manipulators have bought an atmosphere of profitable autonomy.

The revolving door between say congress and the DOJ with huge law firms that represent criminals and wrongdoers shouts tacitly “we are the poster children for conflicts of interest”.

There has been a marriage made in hell. As a result, the health of others is not restored or harmed.

And no one stops this atrophy from occuring- this toxic and anaphylactic death that is occuring to us.

Dan Abshear

alex said...

And now Jack Connors is one of the buyers interested in the Boston Globe...

Is it possible that the "fish rots from the head" story was a plant by some incredibly shrewd marketer on behalf of the NYT?