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Industry payments to academic oncologists common, sometimes sizable compared with salaries
Many academic oncologists at U.S. public medical schools receive considerable industry payments, some of which are sizable compared with their annual salaries, according to a research letter published in JAMA Internal Medicine.
The findings suggest that medical schools should enforce policies to limit industry payments, according to researchers.
“A number of influential oncologists on social media argued that accepting industry payments has little effect on medical school professors because payments were so small,” Jennifer Gill, MS, senior research assistant in the division of hematology and oncology at Oregon Health & Science University, told Healio. “[Although] payments may seem insignificant to some, everything is relative, and we felt it was important to understand what percentage of these professors’ annual income comes from industry. A free meal may not influence a curriculum — although we would argue that it could — but an industry ‘bonus’ of 10% of one’s salary may weigh more heavily on one person.”
Gill and colleagues compared industry payments — which differ from payments to medical centers for clinical research — with 2017 annual salaries of 630 academic oncologists across 14 U.S. public medical schools in nine states, including five schools in California.
Faculty members not included in 2017 state-specific public salary databases, those with salaries less than $100,000 and faculty of medical schools with fewer than 10 oncology faculty members listed were excluded from the analysis.
Researchers obtained data on 2017 general payments — consulting fees, honoraria, payments for serving as a speaker at an event other than a CME program, gifts, entertainment, food and beverage, and travel and lodging — from the CMS Open Payments database.
Results showed 417 oncologists (66.2%) received general payments from industry during 2017. Recipients of the highest mean general payments included professors, chairs and directors within departments (mean, $436,069; median, $433,819; interquartile range [IQR], $351,199-$553,932).
Of the 417 faculty members who received general payments from industry, 78 (18.7%) received payments equal to more than 10% of their annual salary, 45 (10.8%) received payments equal to more than 20% of their salary, 16 (3.8%) received payments equal to more than 50% of their salary, and three (0.7%) received payments equal to more than 100% of their salary.
The three highest general payments-to-salary ratios were 124% ($185,316/$149,532), 124% ($132,696/$106,706) and 242% ($923,938/$380,768).
Across all 14 medical schools, the median general payment from industry-to-salary ratio was 0.8% among physicians with payments. University of California, San Diego had the highest median general payment-to-salary ratio (16%), followed by University of California, Davis (8.5%), and University of California, Irvine (4.6%).
“Anytime a medical professional is reminded of the dangers of industry influence, they should reflect on their ties with industry and how they can remove any unnecessary conflict from their practice, or, in the case of professors, their lessons,” Gill told Healio. “We hope this research letter is a message not just to individuals but to medical schools, as well. Enforcing policies on industry conflict will ensure students are receiving the best medical education.”
Six of the 14 medical schools instituted conflict-of-interest policies that established specific limits on the amount of industry payments faculty receive annually. The Ohio State University had a limit of 20% of base salary, whereas the five California schools had a limit of $40,000 or 40% of base salary, whichever was greater. Researchers noted that at least one faculty member from each of these six medical schools had general payments greater than stated limits.
The eight other medical schools evaluated payment limits on a case-by-case basis.
“We were limited to public medical school salary databases, so there is potential for missing or inaccurate salaries and payments from these sources,” Gill told Healio. “That being said, we are not generalizing our findings to all U.S. medical schools.
“This research letter points out that medical school conflict policies are not always being enforced, some schools do not have strict policies in place, and [although] many professors receive little-to-no industry payments, a small percentage are receiving exorbitant amounts,” she added. “Industry should have no part in shaping medical school curriculum. This letter suggests that we need to increase efforts to ensure this does not happen.” – by Jennifer Southall
For more information:
Jennifer Gill, MS, can be reached at Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239; email: gillje@ohsu.edu.
Disclosures: Gill reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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