We have written a lot about the conflict of interest scandals at the NIH. (See below for links to related posts on Health Care Renewal, plus a citation of a newspaper op-ed.)
We have also noted several times how little discussion there was of this story in the medical and health care literature, and even what is now called the main-stream media (MSM). This appeared to be an example of what Russ Maulitz called the anechoic effect, the silence that greeted any story about concentration and abuse of power in health care.
Thus, I was gratified to see an interview published in yesterday's Los Angeles Times which provided a lot of support to our viewpoint on this scandal. Here are some particularly pithy quotes:
- "If you are weighing in on behalf of the public, I want you to be there on behalf of the public. Don't tread [trade] on your prestige, position, in a way that pretends to be completely objective."
- "I came to the conclusion that we have a systemic problem. They were not just isolated events. They reflected a complete set of rules that had been adopted over the years, which had transformed the culture..... if that's the case, let's bring back the culture to where it needs to be: that is, public first."
- "No limits on stock. No limits on money. No limits. Where were all those holier-than-thou intellects?" "This issue was standing between the history of the NIH and its future."
What is most striking is that the interviewee was the current Director of the NIH, Dr. Elias Zerhouni. Clearly, having the public support of Dr. Zerhouni for unconflicted, ethical leadership of the NIH is a big step forward. The interview also marks a significant crumbling of the anechoic effect (to badly mix metaphors).
Dr. Zerhouni's approach also stands in stark contrast to how leaders of other major health care organizations have reacted to allegations of uninformed, incompetent, self-interested, or even corrupt leadership. The usual way of doing business has been to circle the wagons, deny the problems, and, if pushed very hard, purge the most visible culprit and then declare the problem resolved.
Concentration and abuse of power in health care are widespread problems, as perusal of recent posts on Health Care Renewal demonstrates. We need all the support we can get for informed, competent, honest and ethical leadership of health care organizations. We can now use Dr. Zerhouni as a good example, and hope we can count on his support for the reform of leadership of other organizations.
Previous Posts and One Article
Poses RM. Corruption, incompetence in health care. Providence Journal, December 17, 2003.