RCR Casebook: Conflicts of Interest
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This role play involves a physician-researcher (superstar professor) who continues to take on significant new commitments despite being overextended; a department chair who, while not wanting to diminish his academic superstar's value to the university, is concerned about another new grant s/he wants to take on as Principal Investigator; and an administrator who is a trusted colleague of the department chair and provides a willing ear for how to approach this conflict.
Role Play: Department Chair Role Guide
Character Description: The Department Chair
You are Chair of the Neurology Department at a large academic medical center. You have spent the last few years trying to keep your superstar physician-researcher happy, as s/he is always letting you know about offers s/he receives from other prestigious universities. You know that s/he supports many valuable programs in your department. However, you are increasingly and uncomfortably aware of the fact that s/he plays fast and loose with his responsibilities. Typically, s/he has students, post-docs, and others who work in his/her labs covering many of his/her academic duties. The Sponsored Projects office has brought to the attention of the provost the dubious Effort Reports s/he has submitted, and the provost has asked you to look into the matter, because they fear he would not pass muster with federal auditors. (An Effort Report indicates total university-compensated effort, which may include teaching, research, public service, administrative and other university-related activities).You are especially concerned now that s/he has emailed you that s/he will stop by to have you sign off on his/her proposal to be Principal Investigator on a new NIH institutional research training grant, which would admit four trainees per year, requiring his/her supervision and guidance.
Role Play: Administrator Role Guide
Character Description: Administrator
You are an administrator and trusted colleague of the Department Chair. You chair another major department at the same institution and have had to manage similar academic superstars over the years. Not for the first time, the Department Chair turns to you with concerns that his top researcher is skating on thin ice with the Effort Reports s/he has been submitting. The last thing either of you want is a federal audit that could result in fines or lost funding.
The following are the kinds of questions that a trusted colleague might ask:
- If you refuse to sign the application, what do you think might happen?
- Do you want to retain him at this point?
- Have you warned him that he is vulnerable to a federal audit? Is he aware of increased scrutiny of Effort Reports in recent years? Does he really understand effort reporting requirements?
- Have you tried suggesting he let someone else be Principal Investigator on a grant for a change?
- What do you think is driving his reckless behavior? Is it financial? Self-esteem? Or you or other administrators putting pressure on him?
- What are doing in your unit to educate your investigators about effort reporting and competing obligations?
Role Play: Physician Researcher Role Guide
Character Description: Physician-Researcher
You are an academic superstar. You are a very successful neurologist at a large academic medical center, and the director of the division of critical care neurology. You rotate as an attending physician in the hospital. You are also principal investigator (PI) of two large NIH R01 studies and two clinical trials funded by industry partners. In addition, you chair an IRB, serve as a preceptor for several trainees, and direct a course for medical students. You also serve on a NIH study section, travel frequently as a speaker here and abroad, and are the incoming president of the regional chapter of your professional association. Now, you want to apply to be Principal Investigator on a new NIH institutional research training grant, which would admit four trainees per year. You thrive on keeping a hectic schedule and enjoy the diversity of your commitments. However, because of this lifestyle, your spouse has left you. Now, you have completely immersed yourself into your work.
You have asked a fellow administrator (trusted colleague) to have lunch away from campus so that you can discuss how best to approach the situation with your physician-researcher (superstar professor).
Chair: “The continuing saga of my problem child in the Neurology Department has taken a new turn.
Administrator: "For the worse, I take it?"
Chair: "He just let me know he'll be stopping by to have me sign off on a new proposal to the NIH."
Admin: "So what is the problem?"
You are in your office when your top physician-researcher (superstar) in the neurology department sticks his head in the door.
Physician-Researcher: “Hi, did you get my email?
Chair: "I did.
Physician-Researcher: "Great. All I need is your signature on my application to the NIH…”
Chair: How do you respond?
 The Association of American Medical Colleges (AAMC) and Association of American Universities (AAU) have produced a thoughtful joint report presenting a framework for making conflicts of interest management decisions. The AAMC/AAU Report is available online for free.36. AAMC-AAU Advisory Committee on Financial Conflicts of Interest in Research. Protecting patients, preserving integrity, advancing health: Accelerating the implementation of COI policies in human subjects research. Washington DC: AAMC-AAU;2008.