On the eve of the Sunshine Act’s introduction, Newsweek revisits the sordid situation at university medical schools in regard to conflict of interest with big pharma. Starting in September, American consumers will have access to information about “all payments and other valuables given by Big Pharma to physicians and teaching hospitals.”

This blog has over the years covered so many greed-crazed COI’ers at so many university medical schools that you’d think UD just copies and pastes everything that shows up on Google News. In fact, she’s extremely selective, posting only about those stories involving arrant – sometimes fatal – disregard of patients, plus immense pharma payouts. She’d link you to a few of these stories right now, but they have a triggering effect on her.

Meanwhile, it’s good to keep in mind that med school COI mischief doesn’t stop with the stuff the Sunshine Act illuminates. Given last year’s bad publicity about George Washington University’s business school (this article, which summarizes events, also features the latest form of fallout), one might forget that in 2009 its med school was also in trouble — both on probation and headed by a

provost and vice president for health affairs, [who] also has received money and stock options for serving on the board of directors of Universal Health Services, which owns the university hospital.

Williams was paid nearly $680,000 in annual compensation by GWU, according to the university’s 2006 tax returns, its most recent, and UHS reported in Securities and Exchange Commission filings that he received compensation from the company that calendar year of $122,000, including stock options.

Because he has a stake in the company’s profitability, some at the school complained that Williams had no incentive to push for spending on new equipment and programs at the school. Others said it was not appropriate for Williams to be paid so well when the tax-exempt school is one of the most expensive in the country.

GWU leaders asked Williams to resign from the corporation board and this month accepted his resignation, effective by the end of the academic year.

Ain’t nuthin the Sunshine Act can do about this popular form of self-enrichment.

Just a reminder – and an update – of one of the biggest pharma scandals of the year. Background on this one here. Basically the company gave humongous money to the university, which duly manipulated data for the company’s benefit. In turn, the company duly advertised its product by touting the results it had paid for.

Whoring for pharma: Happening also at a university near you.

A pharm-loving doctor named Stossel
Is a fervent free market apostle.
But Glaxo’s stopped bribing
For over-prescribing,
And Stossel’s upset is colossal.

… happens all over the American university, of course; but some forms destroy the institution and some just cheapen it. I think Derek Bok is right that when for-profit businesses start providing instructors for non-profit universities’ online courses, it’s extremely destructive:

[Northeastern University’s online] instructors mostly do come from “the Northeastern family,” [a campus representative] says, meaning people familiar to the university because they are alumni or have taught the course before as lecturers. But on “one or two occasions,” …the university has needed someone, “and Embanet has provided an instructor for us.”

… Mr. Bok sees a “dangerous trend.” Even though campus officials insist that they control hiring decisions, he doubts that a college would veto a company’s recommendation in a situation in which students were waiting for a class, and time to find a teaching assistant was limited. Mr. Bok emphasizes that he is speaking generally, not about any particular institution. But as a matter of principle, he says, “you have crossed the line” by using a private company to recommend teaching assistants.

“You have now delegated an essential academic function, which is choosing who will assist in the teaching function, to a company,” he says. “You could say it’s not very important. But of course, the way principles break down is because the first thing is not very important.”

Similarly, when pharmaceutical companies, through subcontracted ghostwriting firms, write scientific articles for university professors (articles touting their pills), it’s extremely destructive. It goes on quite a bit – as does corporations running university courses – and it’s extremely destructive.

We find out about it when the lawsuits start happening: When students sue schools on the basis of fraud (as they have for some time been suing the tax-syphon for-profit ed providers), and when the government sues yet another corrupt pharma outfit, as it has most recently successfully sued Johnson & Johnson, we see how the deal works, how universities in search of revenue hand over their academic functions to corporations.

In the Johnson and Johnson matter

the case file includes a list of academic researchers who wrote articles for medical journals that the company allegedly used to overstate the benefits and understate the risks of a blockbuster drug…

A primary investigation underlying the case identified 44 articles written by university scientists and colleagues, many of them joint collaborations that included Johnson & Johnson researchers, described as being overseen in some manner by the company.

Yes, let’s do it together! Let’s run the class together; let’s write the article together. After all, we’re both motivated by the same thing: Pure pedagogical or scientific integrity…

UD was warmed to see the name of Joseph Biederman, a man who has arguably done more than anyone to make the world safe for baby Risperdal, among the university scientists working, er, hand in glove, with Johnson & Johnson.

Some university authors — including Joseph Biederman, a professor of psychiatry at Harvard who gained renown for collecting at least $1.6-million in consulting fees from drug makers …appeared to be more personally aware than others of their misrepresentations…

Dr. Biederman, through a lawyer, declined to comment on his work with Risperdal.

Johnson & Johnson will pay a pittance – 2.2 billion – in penalties for having illegally marketed Risperdal. Joe will keep his trap shut and stay at Bok’s Harvard. All quiet on the western front.

An entire issue of the Journal of Law, Medicine, and Ethics is devoted to the notorious corruption of the pharmaceutical industry, and (of abiding interest to University Diaries) the way pharma-supported university research has corrupted universities.

The rise of pharmaceutical-firm-funded university research changes the social context of research, and along with it, the opportunities and constraints on researchers. [Garry C.] Gray uses a case study of a medical school professor’s first experience with pharmaceutical company-sponsored research in order to examine how funding arrangements can constrain research integrity. The case study reveals that there are conflicts between the norms of commercial firms and universities.

… says UD, smuggling in another totally random musical reference…

Mes amis, you and I will never know the depths of the no-end-in-sight greedy human heart. Jour prospère! But isn’t damn near a million dollars a year (when you throw in all the goodies) prosperous enough for a university president? And the president of SUNY Upstate med school, David Smith, was about to be appointed the new president at Penn State at another huge salary… Poor wretched Penn State, which not only needs to pick its amis with much greater care than it has in the past, but needs to recover from the sixty million plus dollars it’s had to pay out because of its ami Jerry Sandusky.

Enfin, it hired an excellent search firm, a fine tooth comb kind of search firm, and the firm reported to Penn State as well as to SUNY that … well, call him “Paddy” Smith:

Smith’s outside money has been coming from two companies during recent years that are linked to SUNY Upstate: Medbest Medical Management Inc. and Pediatrics Service Group LLP.

Where else is the dude gonna get an extra four hundred thousand a year? From students? He has no choice but to take bribes from companies who get contracts with SUNY! What’s the point of being president of a whole university if you can’t shake down your vendors?

Smith’s unapproved arrangements added substantially to his pay, according to a Nov. 1 letter to Smith from SUNY Chancellor Nancy Zimpher. In the letter, she alerts Smith to a recent review of his income and says he accepted $349,295 from the outside sources without Zimpher’s approval.

****************************

I gotta say – this is one of the few cases of a search firm actually being worth real money. The last thing insanely scandal-scarred Penn State needs is a brand new president they immediately have to fire (paying out a huge severance!) because he’s – reportedly – a sneaky little liar.

Isaacson Miller is the name of the search firm: Make a note of it. The no-end-in-sight greedy heart? E strano! E strano! In other words, fuggedaboutit. But you can always hire a good search firm.

Brings back memories of Mr Risperdal himself, Harvard University’s Joseph Biederman.

Leana Wen, a doctor at George Washington University Hospital, introduces herself to patients like this:

“I’m Dr. Leana Wen. I’m your doctor. I belong to an initiative called ‘Who’s My Doctor?’ that aims for transparency in medicine. I accept no money from drug companies or device companies.

“I do not make any more from ordering more tests or procedures on you, and I also don’t make more for ordering less. I’m telling you this so that you can be sure that everything I do for you is in your best interest.”

A bit awkward as an opening gambit, to be sure, but part of the anti-conflict of interest, full disclosure movement of which Wen has been a part since med school (Wen was president of the indispensable AMSA). As a faculty member at a university whose hospital was recently so rife with conflict of interest at the top that it became a national scandal – it was even put on probation for reasons probably related to its distracted-by-money managers – Wen could not be better placed to draw attention to the still COI-mad profession of medicine.

The major power players of Washington DC are of course particularly prone to market corruptions, as in the latest case of a high-ranking professor/FDA chairwoman having to be pulled back from an embrace with industry:

Dr. Lynn Drake, a lecturer at Harvard Medical School and current chairwoman of the panel that advises the FDA on drugs to treat skin and eye conditions, is scheduled to speak at a conference whose stated aim is to help companies “walk away with strategies to successfully present before a committee and avoid potential roadblocks.”

In a letter sent on Thursday to FDA Commissioner Margaret Hamburg, Dr. Sidney Wolfe, founder of Public Citizen’s Health Research Group, called on the agency to either require that Drake not attend the meeting, or remove her from her position as chairwoman of the Dermatologic and Ophthalmic Drugs Advisory Committee.

… Wolfe said Drake’s participation in the conference, which is being sponsored by PharmApprove, a consulting company, and costs up to $2,199 to attend, “raises concerns that the advisory committee member is approaching the work of the committee from a pro-industry perspective.”

… It is urgent that the FDA develop and articulate a written policy applicable to all advisory committee members to avoid repetition of this type of shameful episode, which could undermine public confidence in FDA advisory committees and in the agency itself,” he said.

Wolfe also drew attention to Drake’s curriculum vita, which is posted on the FDA’s website and which he said contains 32 items that are redacted under an exemption designed to protect trade secrets and other confidential business information. He said he has made a Freedom of Information request for an unredacted copy of the CV, “because the full CV may further elucidate Drake’s background and relationship with the pharmaceutical industry.”

Drake says she had no idea what she was signing up for.

“Either she is naive and signs up for things without knowing very much about them or she actually didn’t know the title of the session she was going to be a speaker on,” [Wolfe] said. “Those things are not really very likely.”

I mean, it’s pretty clear she got caught because Wolfe happened to read a promotional brochure for the conference (which will cost you two thou to attend… or maybe less now…)…

********************

UPDATE: Things don’t look much better these days at GWU’s med school.

Among schools with the weakest [Clinical Conflict of Interest] policies: Saint Louis University School of Medicine, George Washington University School of Medicine and Health Sciences, Weill Cornell Medical College, University of Nebraska College of Medicine, and Case Western Reserve University School of Medicine.

[Harvard University professor Lawrence Summers] consults not only for hedge fund DE Shaw but for venture-capital firm Andreessen Horowitz, asset-management and advisory firm Alliance Partners, stock-exchange operator Nasdaq OMX Group Inc., and for financial services firm Citigroup. He also has a healthy income from speaking — more than $100,000 earlier this year, for example, for a single speech to a conference organized by Drobny Global Advisors.

That is a busy schedule for a full-time faculty member who, like other professors, is allowed only a day a week for consulting — and Summers also chairs the advisory board of the Minerva Project, an online university startup, and holds an administrative role as Director of the Mossavar-Rahmani Center for Business and Government at the Harvard Kennedy School.

This is the same Lawrence Summers who told Professor Cornel West to stop spending so much time on his outside activities and get back to his scholarship — because more was expected of a University Professor.

Harry Lewis, Huffington Post.

Yeshiva University’s Moody’s rating has just been downgraded to Baa1 from A2; Moody’s is currently reviewing the university for further downgrades.

How does a university get to such a disastrous place?

It was not the work of a day. Yeshiva had to make itself so notorious that students didn’t want to enroll, and alumni didn’t want to donate. This took about five years, starting with the brilliant idea of putting Bernard Madoff and Ezra Merkin – both YU trustees – in charge of Yeshiva’s money. Conflict of interest? Who cares.

The financial and reputational hit was a biggie. But Yeshiva was just getting started.

Instead of dealing forthrightly with its misbehavior, Yeshiva said nothing and simply erased Madoff’s name from all mentions on its website. (It couldn’t erase everything: “Madoff’s name was prominent in the program for Yeshiva’s annual Hanukkah dinner and convocation, a major fundraising event, held on Dec. 14 at New York’s Waldorf-Astoria Hotel, three days after he was arrested.”) It then went about characterizing itself as an innocent victim of this mean man and his friend Ezra.

With the Madoff/Merkin mess already destroying Yeshiva’s integrity, extensive sexual scandal now hit the newspapers. Decades of important Yeshiva University rabbis preying on children, or looking the other way while children were preyed upon, are the talk of the town. Yeshiva will probably have to settle hundreds of millions of dollars on the traumatized people suing it.

A third crucial component of Yeshiva University’s catastrophe is its inability clearly to admit wrongdoing, coupled with the continued prominence of people reportedly associated with wrongdoing. Take Hershel Schachter.

The power of the rabbinical school rabbis to intervene in student intellectual and extracurricular life could also undermine [Yeshiva University’s] efforts to compete with secular colleges. Rabbi [Hershel] Schachter, who objected to the study of the Christian Bible, also [said] he sees the work of Geoffrey Chaucer as expendable and that 50 percent of an art history course is probably ‘avodah zara and gilui arayot’ (idolatry and licentiousness).”

Okay, so far just a jerk, the sort of anti-intellectual endemic on fundamentalist university campuses. But there’s more.

Earlier this year a prominent scholar at Yeshiva University, Rabbi Hershel Schachter, was caught on audiotape at a conference in London telling Orthodox leaders that Jewish communities should set up their own review boards to evaluate any complaints of child sexual abuse and determine whether to bother with the police. This contradicts state laws on mandatory reporting for teachers, counselors, physicians and such.

Schachter further discouraged police involvement by warning that accused abusers could wind up “in a cell together with a shvartze, in a cell with a Muslim, a black Muslim who wants to kill all the Jews.” Shvartze is a harshly derogatory racial term. Yeshiva University condemned the remarks but seemingly didn’t discipline Schachter, who didn’t respond to my request Monday for comment.

No comment, of course; and Schachter retains a high rank at YU. So does Kenneth Brander.

Better recruiting is [YU President Richard] Joel’s answer to declining enrollment. Back in June, he tasked Rabbi Kenneth Brander, head of the Center for the Jewish Future, with a special assignment: to “re-invent recruitment strategies,” as Joel put it to the Stern College student newspaper, The Observer, in an October interview.

And here is Brander in the Jewish Daily Forward:

[T]wo men have told the Forward that they tried to warn … Kenneth Brander, about Andron. Brander led the Boca Raton congregation from 1991 until 2005, when he took a post as dean of Yeshiva University’s Center for the Jewish Future.

One man who said that he was molested by Andron for three years told the Forward that he called Brander during the early 1990s.

“I told [Brander], he’s definitely a pedophile,” the man said, referring to Andron. “[Brander said] he would look into it, and he never called me back.”

Another man said he tried to warn Brander about Andron a little more than a decade ago.

The man said he tried to call Brander “four or five times,” but Brander did not respond. So the man said he “had to leave a very uncomfortable message” with someone in the Boca Raton Synagogue office. Later, a “third party” from the synagogue contacted the man to say that the allegations against Andron were “rumors” and that “in any case, it’s behind him,” the man said.

Brander may well be innocent of these charges; but as far as YU’s future goes, it doesn’t matter. The school is in free fall.

George Packard provides context for the Robert Barchi story. Read and understand.

… UD rides into town to save his ass.

Barchi wants to hold on to two corporate money-for-nothing seats. Who wouldn’t? But as the leader of the state senate points out, they are both grotesquely obvious conflicts of interest. The corporations in question even do business with Rutgers.

Barchi would be an idiot to turn down hundreds of thousands of dollars of free money, yes. But his job, and whatever reputation Rutgers has left after its zillions of other scandals, are in peril. What to do? Hm, hm, hm…

So far, Rutgers hasn’t done much of anything. Barchi seems to think he can wait this one out, stonewall until everyone loses interest. UD isn’t sure this is a good move. UD can think of a better move.

Barchi can take for his model here the NCAA’s chief legal counsel, who warns that Ed O’Bannon’s class action lawsuit (details here) “threatens college sports as we know it.”

Take the high road, in other words. Go the dignity route. University presidents on corporate boards, university football and basketball – these are beautiful things, with venerable traditions… things we threaten at our peril… things that are simply the heart and soul of the great American university. When you threaten a president’s ability to double her compensation by attending biannual meetings with a biotech at the Regis Bora Bora, you threaten university life as we know it.

University Diaries, I’ve had occasion to say, couldn’t exist without Yeshiva University. Yeshiva is part of a tiny American university elite, a group of schools so arrogant, so dishonest, so mismanaged, so inbred, so simply without a clue, that their unceasing scandals provide a good deal of this blog’s content.

Yeshiva, furthermore, is a religious institution, which makes its very bad behavior that much more astounding. To a man (there aren’t any women in positions of authority there), the Yeshiva representatives UD has experienced appear to her to be pious hypocrites.

Yeshiva’s latest catastrophe was totally expected. Let me quote in its entirety the short notice the Jewish Daily Forward just placed on its website.

Yeshiva University’s credit rating has been downgraded by a major ratings agency amid large and growing deficits, a falling endowment and fears of costly litigation stemming from recent allegations of sexual abuse at its high school.

Moody’s downgraded Y.U.’s debt from A2 to Baa1, putting it below the median credit rating for similar institutions.

The agency says that the litigation prospects of the alleged sexual abuse victims will largely determine if the debt is downgraded further.

Since its peak in 2007 Y.U.’s endowment has cratered, falling 45%, doing handily worse than the stock market. Y.U.’s reliance on hedge funds, in particular, has been extremely damaging. It was also slammed by the financial crisis and damaged by its entanglement with Bernie Madoff’s Ponzi scam.

Meanwhile, the federal lawsuit filed last week by former students at Y.U.’s affiliated high school, alleging administrative negligence in response to abuse they suffered there, is demanding over $380 million in damages. According to Moody’s the attendant publicity may have large consequences for Yeshiva’s fundraising efforts.

As a commenter on this notice writes, “the major damage to the YU bond ratings is not just because of the lawsuit, but because YU has probably lost the confidence of donors.” One Yeshiva donor, Andrew Sole, tried to warn Yeshiva as far back as five years ago. Read his letter calling for the resignation of the entire board of trustees here. The letter, it goes without saying, was ignored.

And note the word “entanglement” up there, relative to Bernard Madoff’s scheme. Madoff, you recall, was a high-ranking, much-venerated trustee of Yeshiva University up to the moment he was taken into custody. Ezra Merkin was also on the board of trustees at that time, working, in consort with Madoff, the sort of financial magic that has become the stuff of legend. Yeshiva tried to make itself out to be a victim of Madoff’s, but it was an enabler, it made plenty of money off of him while the making was good, and it looked the other way when anyone could see that Madoff’s returns were totally impossible.

“Moral bankruptcy,” Algemeiner newspaper said of Yeshiva University earlier this year. That moral bankruptcy has so disgusted donors that it threatens to become financial bankruptcy.

But can he? The problem with – call it the Squeak Assumption – is that, as economists remind us, one’s perception of one’s financial condition has everything to do with what other people in your immediate world earn.

A few years ago, several of Harvard’s money managers resigned in protest because instead of making the industry standard for their job description (with bonuses and all, around thirty million a year at that time), they were stuck (because of alumni protests about over-compensation) at around ten, fifteen million. A few years ago, a University of Chicago law professor with a household income of close to half a million dollars cried poor in the national press.

If Steven Cohen, whose personal worth is between eight and ten billion dollars, sits on your board of trustees, you, as president of Brown University, are going to be challenged to maintain your self-esteem. No one likes to be poor.

If you want to understand why the new president of Rutgers, Robert Barchi, is, like a total idiot, continuing to engage in flagrant, self-serving conflict of interest, and thereby adding one more outrageous scandal to the ten others going on at that university, you have to understand what I’m trying to tell you. You have to try to put yourself in Barchi’s shoes. In his corporate-board world, clearing one million dollars a year is the absolute minimum, the barest acceptable situation. One million dollars is in fact for Barchi squeaking by. If Barchi has to drop his corporate money-for-nothing and suddenly plummet to $800,000 a year, this is what his world will look like to him:

One walks along a very rough path of the river bank, in between clothes posts and washing lines, to reach a chaotic group of little, one-storied, one-roomed cabins. Most of them have earth floors, and working, living and sleeping all take place in the one room. In such a hole, barely six feet long and five wide, I saw two beds—and what beds and bedding!—which filled the room, except for the fireplace and doorstep. Several of these huts, as far as I could see, were completely empty, although the door was open and the inhabitants were leaning against the door posts. In front of the doors filth and garbage abounded. I could not see the pavement, but from time to time I felt it was there because my feet scraped it…

Unless you understand Barchi’s world, from Barchi’s perspective, you cannot possibly understand how he came to assume the presidency of a university barely recovering from years of financial corruption and immediately set about securing his corporate board memberships.

I suppose it’s some sort of compensation, when the story about your young, already totally blighted university presidency jumps to the New York Times, that the quality of prose being produced about the fiasco significantly improves – even to the point of poetry. Rutgers has moved from storm to storm is lovely, lilting, memorable writing; even as the article in the Times rehearses all the stupid stuff Robert Barchi has overseen in the months since he took over at Rutgers, it sweetens things somehow with this poignant formulation…

UD thinks the poetry resides in the word moved… Think of the similar E.E. Cummings line

my father moved through dooms of love

***************

Perhaps, as John Updike wrote, life’s a shabby subterfuge; certainly the last few years at Rutgers and the UMDNJ have been shabby in the extreme. Under its latest leader, a man who does not even understand the concept of conflict of interest, Rutgers straggles on. And the rain it raineth every day.