Much has been made last week of relationships with industry. During ACC.09, reporters and other stakeholders took note that the ACC had decided not to pursue industry sponsorship of lanyards, portfolio bags and other high-value items (these would have produced nearly half a million dollars of revenue for the College). We did this in order to avoid the “NASCAR effect” of attendees as walking billboards and to visually reaffirm our commitment to responsibility and transparency in our partnerships with industry. But that doesn’t mean that well managed relationships with industry don't have real value for patients and society.

The ACC believes in responsibility and transparency in its relationships with industry, and we have taken many steps to eliminate historic practices that became acceptable to us (and are still in place with many other societies).

BUT we also believe partnerships with industry are absolutely critical to maintaining scientific progress in cardiology and other specialties. Right now, public funding for research and medical education is scarce. Cardiologists already pay for 90-95% of their own educational costs. Our attendees have to pay for everything on their own. Plus, leaving one’s office to attend a meeting like this in itself costs a lot of money in lost income! Digital education is valuable, but does not substitute for real discourse -- and folks would not go online and spend four 8-10 hour days staying up with what we presented.

Industry’s participation in our Exposition Hall (which is totally separated from any connection to educational programs or content), and some industry sponsored non-specific educational grants subsidize the meeting costs and therefore allow for reduced registration charges to the meeting (already over $800 or more for attendees). Also they create the ability to offer simulation, live cases, and innovative educational venues that attract people out of their offices to LEARN -- venues we could not otherwise afford to produce.

JAMA Article
The JAMA article on relationships with industry that was published and discussed broadly last week (ACC Past President Steve Nissen was one of the co-authors) laid out some very laudable and responsible recommendations on relationships with industry but some of the article’s recommendations were overreaching and would undermine patient centered evidence based care by slowing the actual translation of science to clinical practice and patient care. We have to be careful here.

The article failed to recognize that the profession can have responsible relationships with industry. The ACC, for example, has made a tremendous commitment to the highest ethical standards in its workings with industry. There are strict firewalls in place for our staff so that the folks who handle fundraising have no overlap with the folks who plan the content of our programming. Industry has absolutely ZERO influence on our educational programs or the content of our educational products.

In addition, we meet frequently with industry leadership, regulatory groups and legislative leaders to ensure we’re communicating about transparency. Our Industry Forum last year brought together health care and industry leaders to discuss and debate these issues. We determined that there is a need to build a code of ethics for medical specialty societies to follow, and we’re working closely with other organizations to do so. The ACC has also been a leader in being fully transparent—we’re the only medical specialty society I know that discloses all the sources of its funding, including disclosures of trustees, governors, and committee chairs, on our publicly available Web site.

We must continue to move toward responsible, transparent relationships that will allow us to maintain the quality of education and research in cardiovascular medicine, and make sure it actually reaches the point of care and patients! To suggest that there can be no relationships with industry at all is short sighted and questionable in terms of producing the most highly educated, patient centered, and unbiased health care workforce that is otherwise possible.

*** Image from Flickr (niallkennedy). ***