Balancing mission and money in academic medicine

Abstract

All physicians face innumerable financial and ethical decisions throughout their careers. Leaders of physician groups including chairmen of academic departments face these same kinds of decisions, and they bear the added burden of being responsible for the welfare of their colleagues, who are affected by their choices and the biases and values that underlie them. Drs. Gunderman and Cohen have challenged academic thought leaders to examine these issues in their perspective entitled, “The Lure of Profit in Academic Medicine” (1). They admonish academicians to be mindful of the numerous pitfalls awaiting departments that turn their attention more to money than to pursuing their academic missions at a high level. Their observations are well intentioned, well reasoned, and worth remembering whenever an academic department is considering a new venture or a new modus operandi. In thinking about the issues, it is useful to place the kinds of money-generating activities that Drs. Gunderman and Cohen caution us about into two categories. First, there are activities that clearly fall within the core competency and core knowledge of people within departments of radiology. As noted by them, these activities include participation in industry-sponsored work where imaging time is “sold” to industrial sponsors, technology transfer of intellectual property developed within academic departments, teaching activities, and extramural grant–supported research. The second category includes ventures falling outside of the core knowledge and expertise of people in