Moving Toward a Final Resolution of a Medical Center Policy on Stanford-Industry Interactions
During the past year we have had a number of helpful and occasionally provocative discussions about interactions of Stanford students, faculty and staff with industry. I certainly appreciate the value of appropriate and productive interactions with industry, and indeed I hope we can foster and nurture relationships that facilitate our mission in Translating Discoveries. However, I also recognize that some interactions with industry have become too intermingled and are now contaminated by gifts, financial gains and marketing tactics that can blur the boundary between academia and industry. I have addressed this important topic in prior Dean's Newsletters (http://deansnewsletter.stanford.edu/archive/07_25_05.html), and I have shared earlier, draft versions of a policy document aimed at addressing this issue (http://deansnewsletter.stanford.edu/archive/02_21_06.html#3) in order to engage you in a broader discussion.
During the past several months a Policy Working Group of representatives of the School and Hospitals, chaired by Dr. Harry Greenberg, Senior Associate Dean for Research, and staffed by Dr. Kathy Gillam, Senior Advisor to the Dean, have worked diligently with a broad group of faculty and staff throughout the Medical Center to refine the policy recommendations and guidelines. I would like to thank Drs. Greenberg and Gillam for their considerable efforts, willingness to listen to and engage all points of view and commitment to move this process to conclusion. Based on the work that has been accomplished, we distributed the draft recommendations to our Executive Committee three to four weeks ago in anticipation of a discussion of the penultimate document at our June 16th School of Medicine Executive Committee meeting. The current Stanford-Industry Interactions Policy consists of six elements:
- Gifts and Compensation
- Site Access by Sales and Marketing Representatives
- Provision of Scholarships and Other Funds to Students and Trainees
- Support for Educational and Other Professional Activities
- Disclosure of Relationships with Industry
- Training of Students, Trainees and Staff Regarding Potential Conflicts of Interest with Industry
At the Executive Committee meeting some of the key elements were highlighted and discussed, and the policy was unanimously supported. Since we now are moving to closure on this topic, I thought it would be appropriate to share our provisional conclusions with you in some of these key areas. It is important to note, however, that we are awaiting final approval of these guidelines from the Medical Boards of Stanford Hospital & Clinics and the Lucile Packard Children's Hospital. We anticipate that these reviews and, hopefully, approvals will occur in early July. Once that has been achieved we will be able to institute the policy across the Stanford Medical Center -- likely by September 1, 2006.
Some of the key elements of the policy follow:
Gifts and Compensation
- Personal gifts (including small gifts like pens, etc.) cannot be accepted from industry on site -- and acceptance of such gifts is strongly discouraged off-site as well (e.g., at professional meetings or events).
- Gifts or payments cannot be accepted for such activities as listening to a sales talk by an industry representative or changing a patient's prescription.
- Clinical care decisions must be separated from any perceived or actual benefits that might be accrued from industry.
Site Access by Sales and Marketing Representatives
- Once enacted the Stanford Policy will not permit sales and marketing representatives in any patient care area in the Stanford Medical Center except for in-service training by appointment only.
- In non-patient care areas (i.e., research buildings, auditorium, etc), marketing and sales representatives would only be permitted access by appointment, and normally only for such purposes as in-service training for research, clinical equipment or devices already purchased or the evaluation of new purchases of equipment, devices or related items.
- Access would also be permitted by invitation from the hospital pharmacy to obtain information about new drugs.
Provision of Scholarships and Other Funds to Students and Trainees
- Such support must be free of any actual or perceived conflict of interest and must comply with guidelines specified in the policy that will mitigate against these types of potential conflicts.
Support for Educational and Other Professional Activities
- Educational and professional activities must be in compliance with the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support regardless of whether formal CME credit is being granted.
- No meals or other types of food or gifts that are directly funded by industry can be accepted.
- While the Stanford Policy does not apply to meetings outside of the Medical Center and University, it is incumbent on participants to understand whether the financial support by industry is fully disclosed by the meeting sponsor and that the meeting or lecture content is determined by the speaker and not the industrial sponsor.
Disclosure of Relationships with Industry
- Stanford faculty, students or staff are prohibited from publishing articles under their own names that are "ghost-written" by industry employees.
- In their scholarly contributions, individuals must disclose their related financial interest in accordance with the International Committee of Medical Journal Editors (www.icmje.org).
- Those having a direct role in making institutional decisions on clinical equipment or drug procurement must disclose any financial interests they or their immediate family have in companies that might substantially benefit from the decision. They must also disclose any research or educational interest they or their department have that might substantially benefit from the decision.
Training of Students, Trainees and Staff Regarding Potential Conflicts of Interest with Industry
- All students, residents, trainees, and staff shall receive training regarding potential conflicts of interest in interactions with industry.
I want to thank the members of the Policy Working Group for their important efforts on moving this project forward. In addition to Drs. Harry Greenberg and Kathy Gillam, whom I mentioned earlier, other members include: Joshua Callman, Director of Continuing Medical Education; Mildred Cho, Associate Professor of Pediatrics; Gilbert Chu, Professor of Medicine; Barbara Flynn, Manager of the Conflict of Interest Review Program; Ann James, University Counsel; Shashank Joshi, Assistant Professor of Psychiatry and Behavioral Sciences; David Magnus, Associate Professor of Pediatrics and Director of the Center on Bioethics; Darla Mochly Rosen, Senior Associate Dean for Research; Julie Parsonnet, Senior Associate Dean for Medical Education; Geoff Rubin, Professor of Radiology; Christy Sandborg, Professor of Pediatrics; Sheetal Shah, Director of Risk Management Controls and Education; Larry Shuer, Chief of Staff at SHC; Kelly Skeff, Professor of Medicine; and Ian Tong, Chief Resident, Department of Medicine.
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Commencement 2006 Was a Big Success
On Saturday, June 17th the University and School of Medicine held their commencement activities. Despite the hot weather, spirits were high and the mood ebullient. Following a luncheon, families and friends filled the large white tent on the Dean's Lawn that provided both relief from the heat and a community of joy as graduates received their Master of Science, Doctor of Philosophy and/or Doctor of Medicine degrees. Following an invocation by Reverend Scotty McClennan, Dean for Religious Life, two graduating students addressed the audience: Iwei Yeh spoke on behalf of the PhD students and Jason Karamchandani spoke for the MD graduates. They both did an outstanding job. I also addressed the graduating class and then announced the faculty award recipients (see below). For the 2005-2006 academic year, 36 Master of Science degrees were conferred along with 92 PhD degrees and 100 MD degrees.
In addition to congratulating our students for their accomplishments, commencement is also a time to honor faculty who have made significant contributions to their education. Accordingly, I am pleased to list the teaching awards that were announced at the School of Medicine Commencement.
The Arthur L. Bloomfield Award: In Recognition of Excellence in the Teaching of Clinical Medicine
- Laura Bachrach, Pediatrics
- Erika Schillinger, Family and Community Medicine
The Henry J. Kaiser Family Foundation Award: For Outstanding and Innovative Contributions to Medical Education
- Peter Rudd, Internal medicine
Corrected: The Henry J. Kaiser Family Foundation Award: For Excellence in Preclinical Teaching
- Laurence Baker, Health Research and Policy
- Lawrence Mathers,, Pediatrics
- Robert Siegel, Microbiology and Immunology
Corrected: The Henry J. Kaiser Family Foundation Award: For Excellence in Clinical Teaching
- James Baxter, Internal Medicine
- Samuel LeBaron, Family and Community Medicine
- Sherry Wren, Surgery
The Franklin G. Ebaugh, Jr. Award: For Advising Medical Students
- Kuldev Singh, Ophthalmology
The Alwin C. Rambar-James B.D. Mark Award: For Excellence in Patient Care
- William E. Benitz,. Pediatrics
Stanford University School of Medicine Award: For Graduate Teaching
- Arend Sidow, Pathology and Genetics
Stanford University School of Medicine Award: For Outstanding Service to Graduate Students
- William Weis, Structural Biology
If you wish to view the 2006 Commencement celebration you can do so by viewing the streaming video at: http://med.stanford.edu/commencement/
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Symposium on Autoimmunity in Digestive Health and Disease
On Friday, June 23, the Stanford Digestive Disease Center (DDC), held its Annual Center Symposium. The DDC is an NIH-funded center directed by Dr. Harry Greenberg, Senior Associate Dean for Research and Training and Joseph D. Grant Professor in the School of Medicine. Its purpose is to promote research relevant to digestive disease. The Center supports a variety of Cores at Stanford as well as an annual pilot grant program. Friday's Symposium was co-sponsored by the Stanford Institute for Immunity, Transplantation and Infection (ITI) and by the Center for Clinical Immunology at Stanford (CCIS). The meeting attracted over 100 attendees and consisted of eight sessions focused on various components of the immune response as it relates to the gastrointestinal tract and liver. Speakers included a number of invited experts as well as selected Stanford faculty, including Dr. Richard Blumberg (Harvard University), Dr. Mark Davis (Stanford University), Dr. Charles Elson III (Univ. of Alabama School of Medicine), Dr. Eric Gershwin (UC Davis), Dr. Martin Kagnoff (UC San Diego), Dr. Chaitan Khosla (Stanford University), Dr. Bill Robinson (Stanford University, 2006 Symposium Director), and Dr. Samuel Strober (Stanford University). I understand that all of the presentations were scientifically very exciting and worthwhile. Congratulations to Dr. Greenberg and his colleagues for a successful symposium.
[Digestive Disease Center site: http://ddc.stanford.edu/ ]
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Early Matriculation Program Commences
With commencement only days in the past, a group of 2006 Stanford Medical students began the Early Matriculation Program (EMP) on Wednesday, June 21st. As part of Stanford's Center of Excellence, the EMP is designed to increase the number of underrepresented minority and disadvantaged students who plan to pursue careers as leaders in academic and clinical medicine. The EMP provides new students with an introduction to each of the Scholarly Concentrations in the New Stanford Medicine Curriculum, and it will connect students with selected faculty with whom they can begin their activities in one of the Concentrations. The Program also will provide course work in histology and biochemistry, and students will participate in workshops presented by Stanford School of Medicine faculty that will examine careers in academic medicine.
I want to welcome our new EMP students, who will be joined in late August by the rest of the 2006 medical school class.
[Early Matriculation Program: http://coe.stanford.edu/curriculum/courses.html#early ]
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Update on Child Care at Stanford University
Because a number of very appropriate questions have been raised about child care services at Stanford, I asked Ellen Waxman, Director of Faculty Relations, to provide this update on our continuing efforts to address the concerns regarding child care options on campus and within the local community. Her report is summarized as follows.
Ellen reports that the University is in the planning stages to build a new child care center that is anticipated to open in 2008. This new center will offer priority enrollment to faculty and graduate students. More information will be forthcoming as plans develop. Here at the School of Medicine we have been exploring the feasibility of assisting faculty in finding alternate forms of care to the university's child care centers with special consideration to the flexibility, availability, and affordability of the child care.
This summer begins Year 2 of a joint School of Medicine-University pilot program to launch a Nanny and Nanny Share Referral Network. This is a new approach that uses nannies as well as other forms of home childcare. In the pilot phase, it is open to School of Medicine Faculty and University Graduate Students and Postdoctoral Fellows. The program was developed in collaboration with Teresa Rasco, Director of the Stanford Work Life Office, and is administered for Stanford by the Work Life Office. This Office has contracted with an external provider, Children's Creative Learning Center (CCLC), to provide background screening; referral services; and consultation, interview and employment forms to potential Stanford family employers of nanny services. (CCLC is familiar with Stanford because it also manages the Arboretum Child Care Center, and it will manage the new center to be built on campus).
The pilot program is testing the feasibility of creating a Stanford Nanny/Nanny Share Referral Network. CCLC refers nanny/nanny share candidates to families. Families interview the potential candidate and determine whether to offer the individual a position. The family is the employer of the childcare provider. CCLC also attempts to match families to share a nanny or to refer families to nannies who are available to work part-time. As a new service, beginning in July, CCLC will also offer, at no cost, background screenings of potential nanny candidates who were located by eligible Stanford families on their own.
If the pilot program is successful in building a Stanford Nanny/Nanny Share Referral Network, a long-term goal of the program is to test the feasibility of expanding a Stanford referral network to include Licensed Family Home Care Providers. Brochures and Information Materials will be available beginning next month to be followed by Information Sessions scheduled by the Work Life Office. For additional information, please contact, Carol Skladany in the Work Life Office at or 723-2661.
Ellen ends her report by noting cautious optimism about the success of this program, and by again recognizing there is no single solution for issues regarding childcare. The pilot project is progressing to everyone's satisfaction at the end of its first year of operations. However, building a referral network from scratch is a time-consuming and difficult project. CCLC is challenged to locate appropriate nanny candidates (just as individual families are) and it is understandably challenging to recruit potential nannies without immediate prospects for job placement.
I want to express my appreciation not only to Ellen Waxman for her many efforts in this area but to Dr. David Stevenson, Vice Dean and Senior Associate Dean for Academic Affairs; Dr. Hannah Valantine, Senior Associate Dean for Diversity and Leadership; and Dr. John Boothroyd, formerly Senior Associate Dean for Research, Graduate Affairs and Postdoctoral Affairs, who have been especially supportive of this program. Thanks also to Provost John Etchemendy for his support of graduate student participation in the pilot program.
I hope that this pilot program and other resources will help address the important challenge of childcare at the School of Medicine and throughout Stanford University. I look forward to hearing about further progress in this and other programs.
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Supporting Academic Career Development.
In the last issue of the Dean's Newsletter I discussed some of the issues and challenges that can impact academic career development (see: http://deansnewsletter.stanford.edu/archive/06_12_06.html#3), particularly for clinical faculty. Over the years we have tried to provide support for faculty development, and I am pleased to let you know that Dr. Hannah Valantine, Senior Associate Dean for Diversity and Leadership, has informed me that her Office is sponsoring two workshops to provide faculty with career development information and skills. They are as follows:
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Scientific Writing: Taught by Michaela Kiernan, Ph.D., Senior Research Scientist at the Stanford Prevention Research Center, July 12, 4-6 p.m., Alway Building, Room M112. This workshop will focus on six practical techniques to improve clarity and conciseness across all sections of journal manuscripts and grants, when and how to use the techniques, and on improvement of writing skills for journals and grants.
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Grant Writing: Taught by Marilyn Winkleby, Ph.D., Associate Professor of Medicine at Stanford, July 20, 4-6 p.m., Alway Building, Room M112. This workshop will focus on different types of grants, the review process and scoring criteria, integrating scientific ideas into a clear, convincing 'story', and ideas for advocating one's expertise and ideas to funding agencies.
Drs. Kiernan and Winkleby have taught these workshops successfully at Stanford and other universities, and I encourage interested faculty to take advantage of this opportunity. Register by sending an email to indicating which workshop you wish to attend. Please be in touch with Barb Miller at 725-8402 with any questions about the workshops.
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As you know, in response to requests from the Provost, the School of Medicine has been very active in implementing both education and programs aimed at reducing peak-hour traffic. I have previously reviewed some of the early "Phase I" actions on this topic in my April 17th Dean's Newsletter (see: http://deansnewsletter.stanford.edu/archive/04_17_06.html#3).
The next phase in this effort, "Phase II," was outlined last week by Julia Tussing, Managing Director of Finance and Administration, at a meeting of department Directors of Finance and Administration and Trip Reduction Representatives (staff assigned to spearhead this effort within departments). The Phase II effort will involve a meeting of each staff member in the School with a Trip Reduction Representative, supervisor, or other leader to jointly develop a commuting and work plan that will satisfy the needs of the employee and the department and will at the same time contribute to the trip reduction effort. These meetings will be spread over the next two months, with completion scheduled by September 1.
It is important to emphasize that these individualized plans, as well as the other related activities of the Trip Reduction program, need to be accompanied by a cultural shift in the School of Medicine community towards openness to trying new ways of getting work done. As the Trip Reduction program has unfolded, it has become clear that it is related in dynamic and synergistic ways with other forward-looking and transformative efforts in the School. These include planning for the movement of different groups to off-site locations; efforts to be more environmentally aware in our work activities (Stanford's "carbon footprint"); discussion and implementation of work/life balance improvements; and focus on health issues. Among the many benefits of changing commuting habits and moving towards more flexible work plans are less pollution, lower stress, better health, higher productivity, and more effective technologies for a mobile work force.
It won't surprise you to know that I am a strong proponent of exercise as one way of improving health and well-being. For those able to commute by walking or bicycling, the changes catalyzed by the Trip Reduction program could be viewed as a help rather than hindrance. Indeed, a number of faculty and staff have commented on how much better they feel now that they are biking to work or walking from the Caltrain, for example. Of course I recognize that this is not feasible for all faculty and staff.
Thank you for your individual efforts to reduce the number of car trips you make to campus, especially during peak hours, and for your cooperation in developing an individual commuting and work plan or facilitating the efforts of staff in your areas to do so. I look forward to seeing the results of the Phase II Trip Reduction efforts over the coming months.
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Outdoor Science Talks at the Cantor
The Stanford Office for Science Outreach, the Cantor Center for Visual Arts, and Stanford Continuing Studies join together to invite you, your friends, and family (high school age and up) to campus this summer to experience the wonders of art and science. Come around 5:00 pm and wander through the acclaimed Cantor Museum, then buy dinner and/or drinks at the Museum's Cool Café, and join us at 7:00 pm on lawn chairs outside of Cantor for a fascinating glimpse into the world of scientific research.
On five Thursday evenings throughout the summer, Stanford will present lectures from its top researchers on subjects ranging from an environmental success story to the unraveling of mysteries of the human body, the earth, and ancient texts. The lectures will be delivered in lay terms that the general public can understand. Plenty of time will be made available for questions and answers following each talk. Both entrance to the Cantor Museum and the lecture series are free to the public. Several hundred people can be accommodated.
An organic buffet BBQ dinner will be available for purchase at the Cool Café in the Museum from 5:00 until 8:00 PM, with both meat and vegetarian options, along with wine, beer, soft drinks, desserts and coffee (cash only).
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Back to Life -- The Rebirth of the Monterey Coast (An Environmental Success Story for a Change)
Stephen Palumbi -- Professor of Biological Sciences
June 22
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Using Evolution to Understand Human Growth and Disease
Matthew Scott --Director of Bio X
July 6
Details: http://events.stanford.edu/events/90/9036/
- 100 Years after 1906: A Century of Progress in Understanding Earthquakes and Their Effects
Mark Zoback -- Professor of Geophysics
Mary Lou Zoback -- Senior Research Scientist with the USGS
July 20
Details: http://events.stanford.edu/events/90/9037/
- Archimedes: Ancient Text Revealed with X-ray Vision
Uwe Bergmann -- Physicist, Stanford Linear Accelerator Center (SLAC)
August 3
Details: http://events.stanford.edu/events/90/9038/
- Human Embryonic Stem Cells: Science, Ethics, and Politics
Julie Baker -- Assistant Professor, Genetics
Hank Greely -- Professor of Law and Professor, by courtesy, of Genetics
(Dean Pizzo will be hosting)
August 3
Details: http://events.stanford.edu/events/90/9039/
Bio-X Symposium 2006: Regenerating Life,
SAVE THE DATE: November 10-11, 2006
http://biox.stanford.edu
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Gary K. Schoolnik, Professor of Medicine and of Microbiology & Immunology, has been chosen by the Hewlett Award Committee as the 18th recipient of the Albion Walter Hewlett Award. The Hewlett Award was established by the School of Medicine in 1983 to honor "the physician of care and skill who is committed to discovering and using biologic knowledge, wisdom and compassion to return patients to productive lives."
Profile: http://med.stanford.edu/profiles/Gary_Schoolnik/
Gerald M. Reaven, Emeritus Professor of Medicine, is the 2006 recipient of the Endocrine Society's highest award -- the Fred Conrad Koch Award. This award is presented annually to recognize exceptional contributions for endocrinology and includes a $25,000 honorarium.
Profile: http://med.stanford.edu/profiles/Gerald_Reaven/
David A. Stevens, Professor of Medicine (Infectious Diseases and Geographic Medicine) at the Santa Clara Valley Medical Center, has just been awarded the ISHAM Lucille Georg Award by the International Society for Human and Animal Mycology Council, in recognition of his outstanding scientific achievement in medical mycology. The award will be presented at the Congress in Paris this week.
Profile: http://med.stanford.edu/profiles/David_Stevens/
Sharon Hunt, Professor of Medicine (Cardiovascular Medicine), has been selected to receive the 2006 Laennec Master Clinician Award from the Council on Clinical Cardiology, in recognition of her contributions and achievements in the field of clinical cardiology. The award will be presented at the American Heart Association Scientific Sessions held in Chicago in November.
Profile: http://med.stanford.edu/profiles/Sharon_Hunt/
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Garry Gold has been promoted to Associate Professor of Radiology, effective 6/01/06.
Profile: http://med.stanford.edu/profiles/Garry_Gold/
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Paul Keall has been appointed to Associate Professor of Radiation Oncology, effective 7/01/06.
Profile: http://med.stanford.edu/profiles/Paul_Keall/
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Joseph Liao has been appointed to Assistant Professor of Urology, effective 7/01/06.
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