Conflict of Interest and Positive Leadership- When History Repeats.

Posted on | June 21, 2012 | Comments Off on Conflict of Interest and Positive Leadership- When History Repeats.

Mike Magee

One of the good things about getting older – at least for writers – is that stories reappear from the past but with a different twist. In fact, when stories reappear, frequently they come in two’s or three’s, and the new story is at the intersection.

Here’s an example from this week. Eric Topol was in the news.(1) I knew him as the campaigning geneticist and director of cardiovascular medicine at the Cleveland Clinic who was way out in front in questioning the safety profile of Merck’s Vioxx and exposing conflict of interest between academic medicine and pharmaceutical companies back in 2001.(2,3)

As director of the Pfizer Medical Humanities, I had an inside view of Pfizer’s take (with their close cousins to Vioxx, Celebrex and Bextra). At the same time, I was conducting independent social science research on trust and confidence within the evolving patient-physician relationship and working hand-in-hand with AAMC president Jordan Cohen MD and his staff on the conceptual design and creation the “AAMC Humanism in Medicine Award” as he was preparing to release the 2002 “AAMC Task Force Issues Report on Institutional Conflicts of Interest in Research”.(5)

As Dr. Topol and other’s succeeded in achieving a critical re-examination of Vioxx and the system of drug approval and DTC promotion in general, he ended up in an “unusually public dispute” with the leadership of his own institution, and they ultimately parted ways in 2006 – at about the same time I left Pfizer.(3) Limiting horizons was enough to accomplish both transitions. Cleveland Clinic messaged Topol by eliminating his Chief Academic Officer position, and Pfizer messaged me in a less transparent but equally clear manner.

Transparency, independence, commercial interest, professional opportunity for advancement and growth, and organizational dynamics and leadership were intermingled in those years. They still are. Arguably, Pfizer, Merck, Cleveland Clinic, and even the AAMC had and have their share of saints and sinners.

A decade ago, in a book titled “Positive Leadership”, I said, “Physicians are neither saints nor sinners. They are simply human beings like you and I. What determines the movement of their organizations toward good or evil are two things. First, who is leading their organization at the time. Second, what is happening in the environment. Of the two, who is leading is the most important because a positive leader not only provides a great role model for the organization but can also help reshape a challenging environment.”(6)

So why was Eric Topol in the news? In late 2006, he went to Scripps Health and The Scripps Research Institute to the post of Chief Academic Officer and Professor of Translational Genomics and head of their Translational Science Institute. This week, Topol announced the “Wellderley Study” that will soon complete the mapping of 1300 robust octagenarians who are thriving at advanced ages. Initial surveying and testing did not reveal a common set of behavioral threads to explain their successful longevity. Says Topol, “We think it’s in their genes.” Two interesting final sidelines. First, the news story made a point that Merck and Pfizer are watching the results closely. And second, the clinical trials director of the “Wellderley Study” is registered nurse Sarah Topol, Eric Topol’s daughter.(1)

References:

1. Flinn R. Robust Octogenarian’s Genes Seen Holding Secrets of Aging. Bloomberg News. June 20, 2012. http://www.bloomberg.com/news/2012-06-20/robust-octogenarians-genes-seen-holding-secrets-to-aging.html

2. Mukherjee D, Nissen SE, Topol EJ (2001). “Risk of Cardiovascular Events Associated With Selective COX-2 Inhibitors”. JAMA 286 (8): 954–959. DOI:10.1001/jama.286.8.954. PMID 11509060.

3. Abelson, Reed; Stephanie Saul (December 17, 2005). “Ties to Industry Cloud a Clinic’s Mission”. New York Times.

4. “Dr. Eric Topol Named Gary and Mary West Chair of Innovative Medicine – Scripps Health – San Diego”. Scripps.org. 2009-06-02.

5. AAMC. News. AAMC Task Force Issues Report on Institutional Conflicts of Interest in Research. https://www.aamc.org/newsroom/newsreleases/2002/82660/020923.html

6. Magee M. “Positive Leadership”. Spencer Books, NY,NY. 2003. http://spencerbooks.com/books/posleadership.html