Thomas P. Stossel, MD, supports medical-industry relations as mutually beneficial.

Medical Industry Breakfast keynote speaker Thomas P. Stossel, MD, drew a parallel between the story of The Emperor's New Clothes and the current environment in medical-industry relationships during Monday's 2011 Medical Industry Breakfast. He views his role as one of the lone, discerning boy who cried, "The emperor has no clothes," while he ascribed the role of the deceptive tailors to the voices decrying the beneficial relationships between industry and medicine. Dr. Stossel is active in the Association of Clinical Researchers and Educators (ACRE), which advocates the value of physician-industry collaboration. "Where," he asked, "has all this concern led?"

"We have gone from bad to worse," he said. "We have immense regulatory issues and massive confessions where we disclose our relationships to industry, and these are used to initiate a whole variety of inhibitions in freedom of speech, freedom of association and reward for excellence."

All corporate payments to physicians now are disclosed. Peer-to-peer speaking has been curtailed, and physician-industry relationships preclude editorials, journal review articles or service on guideline or Food and Drug Administration review panels.

The reasons given for these restrictions are "that those in industry allegedly live in a separate moral universe than medicine," Dr. Stossel said. "The idea is that those who work for industry are obligated to lie, cheat, and steal for profit and for your investors."

Says who? The emperor's deceptive tailors who have launched the conflict of interest (COI) mania, he said. The evidence for these medical and lay media COI messages do not stack up to reality.

Three years ago, Dr. Stossel put two Cornell University undergraduates to work to survey 101 papers in high-profile journals from the Journal of the American Medical Association to the New England Journal of Medical on physician-industry relationships. Ninety-six percent of the articles emphasized the risks of those relationships. Less than half (44 percent) presented evidence to underpin those conclusions about risk, he said.

"There is no evidence at all about the effect of physician-industry relations on patient outcomes, yet 76 percent of these papers claim patient harm," Dr. Stossel said. "Less than half (43 percent) acknowledged an alternative viewpoint."

In contrast, only a handful of papers emphasized benefits of medical-industry relationships based on evidence that did not draw inferences about patient care, he said.

It's the "trouble stories" in the lay and medical media that drive legislation, and often "they are not what they are cracked up to be," Dr. Stossel said. Also the perception is floating around about an alleged "cozy relationship" between physicians and medical industry, "though no evidence exists" for commercial bias in continuing medical education.

"Despite daunting obstacles, industry relationships have delivered huge value," Dr. Stossel said. "Evidence that relationships compromise scientific integrity is weak or false, but legal administration and legal strangulation is harming innovation and education and bodes ill for better patient care."

Amilu Stewart, MD, FACS, reports on the industry relations survey of Fellows.

Prior to the keynote address, Amilu Stewart, MD, FACS, Chair of the Corporate and Foundation Relations Committee, American College of Surgeons (ACS) Foundation, presented results of the ACS Survey of Fellows Regarding Industry Relations. Invitations were sent to 27,021 individuals, resulting in a 9.6 percent (2,582) participation rate in responses to three survey questions.

From the survey, 13.3 percent (341) of respondents said they had developed a product in collaboration with medical industry that had benefitted patients. Additionally, 9.7 percent (247) of respondents said that they had developed a surgical procedure in collaboration with medical industry that had benefitted patients. Finally, 45.7 percent (1,172) respondents said that they had participated in a clinical trial in collaboration with medical industry that benefitted patients.

"This was an important survey for us to complete because we had no concept of how involved our Fellows were in collaboration with industry," Dr. Stewart said.

During the Medical Industry Breakfast, words of welcome were also offered by Thomas R. Russell, MD, FACS, Chair of the ACS Foundation Board of Directors, and David B. Hoyt, MD, FACS, ACS Executive Director and ACS Foundation President.

Dr. Russell said the ACS Foundation is pleased to sponsor the Medical Industry Breakfast each year to promote discussions on issues of mutual interest to the medical profession and industry.

"We cannot educate or innovate in what we do without our relationship with industry," Dr. Hoyt said. "This is an incredibly important relationship, and I want to do everything to foster and continue that."