Summary of the Acre Inaugural Meeting

Abstract

The charter meeting of the Association of Clinical Researchers and Educators (ACRE) provided a powerful set of arguments against assertions that physician-industry collaboration is harmful and represents a "conflict of interest." Such collaboration has, in fact, improved medical care for patients, a case made overwhelmingly by patients and patient advocacy groups at the meeting. The contentions that physician-industry collaboration is problematic are not based on evidence. They depend on unjustified generalization from inevitable, sometimes egregious, but vanishingly uncommon adverse outcomes of industry-physician interaction without reference to how so much more commonly these interactions add value. Furthermore, the claim that physician-industry collaboration is unprofessional is refuted by rational scrutiny. Indeed, the term "conflict of interest" itself is vague, inviting subjectivity and deserving to be rejected. The unwarranted success of conflict of interest regulation has prevailed because of the failure of physicians, educators, and innovators, through apathy and intimidation, to pay attention to its fallacies and resist its dangers. It has arisen from activist ambitions and from misalignment between the purposes of medical practitioners, educators, and innovators and those of administrators in medical journals and in academic medical centers. The media and politicians have not appreciated these misalignments and have accepted conflict of interest arguments at face value. Regulation emanating from conflict of interest criticism is confusing, onerous, expensive, disrespectful, and damaging. Prohibitions against speaking about medical products inhibit physician and patient education concerning rapidly emerging and complex therapies. Input by physicians cognizant of compliance requirements into such presentations should be encouraged. Restrictions to the free flow of corporate support of academic health centers, professional societies, and patient organizations threaten to delay medical innovation and education.