Harvard Imposes Stricter Pay Rules on Doctors

Doctors at Harvard Medical School will no longer be able to receive payment for certain speaking engagements, or accept gifts and travel junkets under a stricter new policy scheduled to go into effect beginning in January. The new limits on faculty income sources -- one of the most stringent in the country -- are aimed at eliminating concerns about potential conflicts of interest.

In addition to setting tighter rules on speaking fees and corporate gifts, physicians will be required to report payments on the school’s Harvard Catalyst website. Under the new policy, the school will also review requirements on income from faculty board memberships with for-profit companies. (The rules apply to both clinical and nonclinical faculty.)

“In all cases where financial interests are involved, an essential antidote to potential harm is transparency,” said Jeffrey S. Flier, dean of HMS Dean, said in a report on the Harvard Gazette. “And so disclosure of relevant financial interests, both internally and for the first time publicly, will address this concern.”

The limit on speaker fees extends to speakers bureaus — doctors will now be prohibited from participating in industry speakers bureaus presented industry-provided speeches and information. Flier said the restriction was designed to allow HMS faculty to “maintain their intellectual control.”

The American Medical Student Association said Wednesday it approves HMS’s updated policy. “Two years ago, AMSA called for the elimination of conflicts of interest surrounding the interactions of the pharmaceutical companies and the Harvard medical community. As the organization leading the PharmFree movement, AMSA is pleased to see Harvard using scientific evidence over marketing and doing what is ultimately the best for patients. We hope to see other medical centers follow this example,” John Brockman, AMSA national president, said in a statement.

So … no gifts, no speaker fees, cutbacks on income from board memberships. Is there anything Harvard doctors can make money on the side doing under the new rules? Turns out there’s more than just a bit of wiggle room. National Public Radio runs down these “5 Things a Harvard Doctor Can Still Take Industry Money For”:

Speeches. The new rules say physicians can’t give speeches if corporations or industries tell them what to say, but they can get paid to speak if they craft the content of the speech on their own.

Board memberships. Harvard doctors can participate in corporate board memberships, or work on other industry projects for cash, but they must report all payments above $5,000 and the information will be published on the Harvard Catalyst website.

Gifts. Rules here are the least flexible -- physicians can accept reimbursement for meals and travel only if they’re for strictly business purposes.

Research. Doctors can still get paid by companies for research and testing, but not more than $10,000 per year, per company (the old limit was $20,000). Faculty members also can’t have more than $30,000 in equity in publicly traded companies from which they receive income (equity in private companies is prohibited).

Continuing Education. Courses doctors have to take to get their licenses can silo be sponsored by industry sources, but the sponsorship of the courses needs to be spread out over a bunch of companies -- no one company can pay more than half the cost.