HRDI Story Remains Mainly Anechoic

We recently posted about the settlement between the Healthcare Research and Development Institute (HRDI) and the Connecticut Attorney General Richard Blumenthal. HRDI is a for-profit owned by a number of the top executives of some of the US best known hospital systems and academic medical centers. According to an article in the NY Times, HRDI gives a limited number of drug, device, and biotechnology companies access to these executives, for a stiff fee (see earlier post here). Announcing the settlement, Blumenthal called HRDI "an anticompetitive, secret society, an elite and exclusive club of premier hospital executives and select hospital supply businesses that restrained competition to the detriment of patients and providers."

In our last post, I speculated whether this story, which noted the involvement of the leaders of some of the US most prestigious hospitals and health care system in such a "secret society," would lead to any further investigation of these leaders' roles, or any repercussions. Based on our observations of the "anechoic effect," the lack of echoes usually produced by stories about mismanagement by, conflicts of interest affecting, or corrupt behavior of leaders of health care organizations, I predicted that not much would happen.

So far, my prediction seems to be holding. Of the 30-odd leaders who were members of HRDI, local media have addressed only 3, although these efforts were revealing.

• In Texas, television station KGBT tried to interview Joel Allison, President and Chief Executive of Baylor Health Care System in Dallas, but Allison had "no comment," and that is as far as that story goes.
• In Tennessee, the Memphis Commercial Appeal interviewed Stephen C Reynolds, President and CEO of Baptist Memorial Health Care, and chair of HRDI. Reynolds asserted "there was no wrongdoing found," apparently because there have been no criminal charges, denied HRDI was secretive, explained the rule that allowed only two companies from any sector to participate as a measure to improve "diversity," denied that money he received amounted to a "conflict of interest," because "HRDI has had a strong conflict of interest policy," and declared the high purposes of the organization "to solve common issues in health care and improve services to patients."
• In Utah, the Salt Lake Tribune independently reported on the involvement of Bill Nelson, the CEO of Intermountain Healthcare. The article stated, "Nelson and Intermountain trustees defended the association as a valuable forum for feedback and for tapping health care's best minds, saying it would have been inappropriate for Nelson not to take part." Nelson also emphasized the lack, so far, of criminal charges, Nelson, noting there have been no charges filed or admissions of wrongdoing, accused Blumenthal of 'creating the illusion of impropriety' where none exists." On the other hand, the article included some new material which challenged Nelson's assertions that there were no problems with his involvement in HRDI. "Mark Leahey, executive director of the Medical Device Manufacturers Association, condemned HRDI for its lack of transparency. Leahey, whose board includes executives of Utah companies, said he had no clue about HRDI or its business model until Blumenthal began investigating. Up until a few months ago, Leahey said, a pass code was needed to access any information on the group's Web site. 'These guys were making $30,000 and $50,000 a year to rub shoulders with top pharmaceutical and medical device companies,' Leahey said. 'They had fiduciary duty to their hospitals and they were essentially getting kickbacks from suppliers.' Furthermore, at least one Intermountain trustee was not happy with Nelson, "The vendors were paying to have these top executives come and consult with them and we knew that. We didn't like the consulting fee, but we didn't require him not to take it."

So far, the HRDI story has had few echoes in the health care media, although the ACP Observer did run a brief item on it.
My first comment is that it is a sad day for health care when hospital and health care systems CEOs assert that they can demonstrate their integrity by the fact that they have not yet been indicted for any crimes. In my humble opinion, the ethical standards for health care leaders, whose decisions affect the well-being and lives of patients, ought to be a bit higher than merely avoiding indictment.
My second comment is that, as expected, there seems to be reluctance in the "main stream media" to take up questionable conduct by the leaders of some of society's most respected organizations. But if these organizations are to deserve the respect they have historically received, their leaders ought to subscribe to the highest ethical standards, not to to be content to assert, to paraphrase one of our less respected former presidents, "I am not a crook."