My Favorite Subject: Conflict Of Interest

My Favorite Subject: Conflict Of Interest

By

Leonard Zwelling

https://www.nytimes.com/interactive/2022/09/13/us/politics/congress-members-stock-trading-list.html?searchResultPosition=1

The front page of The New York Times on September 14 has a huge article about the 97 members of Congress who have made stock trades in industries over which their committees had jurisdiction. The total number of trades reported is in excess of 3700.

You see, the rules really are different for them.

As many of you know, I was the Vice President for Research Administration at MD Anderson when conflict of interest hit the newspapers and the corner office simultaneously when the Houston Chronicle and Washington Post reported then president John Mendelsohn’s commercial interest in the ImClone drug he had developed and which was being tested at Anderson despite the fact that none of the patients on the trial of the drug were aware of the president’s holdings, which were considerable. He had made $6 million in one day when he sold some of his stock. This reveal in the press led to both the president and me being castigated in the op-ed section of the Chronicle. Why me? Because I tried to rationalize the president’s holdings to the press. I was an idiot. There were so many times I should have given up that job when I was placed in a compromising position. I tried to talk my way out of it even when I had done nothing untoward. I was getting good at making excuses.

This then led to the development of a much stricter conflict of interest system at Anderson which led to electronic data base of faculty holdings and a new committee to oversee the process. That was a faculty-led committee by the way although the president could overrule any decision made by the committee as to what faculty members could own in relation to their work or knowledge of research results.

That was 20 years ago, yet apparently, in Washington, DC they are still partying like it’s 1999.

There really is only one way to deal with conflict of interest—eliminate it. There is no disclosure or management plan that can undo the actions of people with fiduciary responsibilities to institutions and patients yet allow them to profit from inside information. That federal legislators and federal judges continue to do so is no surprise, but it is an immense disappointment.

The time has long since passed the point when all stock holdings by any legislator or his or her immediate family must be put in a true blind trust for the duration of the law maker’s service. The same ought to be true of the judiciary.

Now let’s move to a different kind of conflict of interest.

Lately, the powers that be at Anderson have been hiring outside attorneys to intimidate faculty and staff alike to get what the powers want—usually someone gone. If the leadership wants to know why burnout is such an issue and why yoga can’t cure it, all they need to do is look at the fear they have injected into the faculty body of MD Anderson. That too is a conflict. When leadership uses its power to scare the daylights out of those it leads, that is no longer shared governance. That is autocracy.

Again, this blog takes the position that the current leadership of MD Anderson is wholly out of control and that only an intervention from Austin can provide some relief. I am quite sure it will happen sooner or later. I just wish it could be sooner, but I also wished 20 years ago that conflict of interest in academic medicine would go away. It won’t. There’s too much money to be made and too much greed in the system.

And after all, who can blame the doctors when our political leaders are so corrupt. Everyone wants a piece of the action. But, soon, there will be no action worth having a piece of because the patients will trust us about as much as they trust politicians. Not at all.