The American Society for Surgery of the Hand (ASSH) Corporate Advisory Council recently gathered in Chicago to create the first ever ethics guidelines for industry relations created by a collaborative effort between physicians and industry representatives. The guidelines, developed jointly in the spirit of transparency and the highest ethical standards, will be followed by the hand surgeons of the ASSH, an organization that has been a leader in developing standards to both embrace the support of industry partners while also ensuring that such support is accepted without conditions or restrictions.
In 2008, the Corporate Advisory Council, comprised of key leadership both in medicine and industry, was formed by the ASSH Board of Directors (Council) as a means of monitoring and developing clean and ethical relationships. While serving as President of the Hand Society from 2007-08, Steven Z. Glickel, MD, conceived the initial concept of the “10 Commandments”. Dr. Glickel, chair of the Hand Service at Roosevelt Hospital in New York City, believed it was necessary to develop a clearly defined standards to be followed by hand surgeons. The standards ensure that any appearance of impropriety or the perception that a physician’s ability to independently make decisions regarding the care of a patient would be avoided. William Seitz, Jr., MD was serving as the ASSH Commercial Support Chair when Glickel conceived the idea. They worked together to move the concept of standards to a concrete reality. Dr. Seitz, who is at the Cleveland Clinic, is now chair of the newly formed Corporate Advisory Council. Robert Szabo, MD, (UC Davis) is the current ASSH President, and he has continued the work to support the initiative. L. Andrew Koman, MD, Chair of the Department of Orthopaedics at Wake Forest, was also a key surgeon and president of the ASSH at the time the Corporate Advisory Council had its inaugural meeting.
ASSH’s “10 Commandments” will be strictly adhered to by physicians and corporations. These guidelines, shown below, are also part of the American Foundation for Surgery of the Hand’s commitment to maintaining the highest ethical standards while engaging in relationships with industry in support of hand and upper extremity research. Fred Fakharzadeh, MD, President of the AFSH, believes these “commandments” will help both industry leaders and surgeons have the kind of relationships that will ultimately benefit patients.
The 10 Commandments are as follows:
It is the belief of the leadership of the ASSH that a relationship between medical societies representing physicians and commercial corporations is necessary and beneficial for the future of medicine. It is essential for industry to consult with physicians for their medical expertise. It is necessary for the medical professionals to rely on industry to support education in order to stay abreast of the latest technology within their chosen field.
In order to avoid any appearance of impropriety or perception that a physician’s ability to independently make decisions regarding the care of the patient has been compromised, we will henceforth strictly adhere to these following guidelines (“our ten commandments”):
1. Industry is strongly encouraged to support educational activities to increase knowledge and the skills necessary to improve patient care through the American Society for Surgery of the Hand (ASSH).
2. Industry is strongly encouraged to provide support for research through the American Foundation for Surgery of the Hand (AFSH). The subject and content of the research will be determined by the ASSH/AFSH. Corporations will not control the content of supported research.
3. The ASSH/AFSH will clearly define research programs and methods of selection of topics and researchers receiving donated funds. The AFSH will provide annual updates to donors on the use of those funds.
4. Physicians will be consulted and involved in the development and design of new products as deemed necessary by the device company following a comprehensive review of the specific project requirements as well as the physicians’ credentials, qualifications and expertise on the subject matter by the company.
5. Consulting and design activities will be reimbursed by industry at a fair market value on a per-activity or per-time basis. No ASSH members will accept gifts, funding for companion travel, sponsorship of recreational activity, entertainment, or sports events.
6. ASSH Members and industry will be parties to explicit contracts regarding the scope of service and reimbursement for service.
7. ASSH members will not demand or accept unreasonable reimbursement for travel, meals, and lodging, for being involved in an educational activity.
8. All funding to support education and research will be controlled by the ASSH and the AFSH.
9. Companies will not influence the control of educational or research activities.
10. All relationships will be disclosed and readily available to the public.
The Corporate Advisory Council of the American Society for Surgery of the Hand will be an ongoing dynamic body dedicated to ensure the ASSH mission of improving patient care through the enhancement of education and research and the development of new technology.