Tuesday, April 8, 2014

AMC Leaders on Corporate Boards—A Modest Proposal

Dr. Roy Poses over at Health Care Renewal has for some time been speaking out about conflicts of interest posed by leaders of academic medicine and supposedly “not-for-profit” health systems who also rake in big bucks for sitting on the boards of large corporations such as drug companies and other firms that often do business with those same health centers. He most recently called attention to a research letter in JAMA that provides some of the first data on the frequency of these ties (see link in blog post):

Dr. Poses notes a number of serious ethical concerns that result from these board relationships. He is most worried about the way that a small group of very wealthy corporate insiders seem to have formed an old-boys-and-girls club that runs not only the corporate sphere but increasingly the world of health care as well, and how in the process the interests of ordinary folk get left behind. There is also the narrower question of the role of these people on those corporate boards which forms a sort of Catch-22. These corporations, as we have detailed ad nauseam in this blog, often take actions that go against the public interest. If (say) a university president is a member of the board of directors, then the prez presumably should speak up and demand that the corporation cease and desist all such behaviors. If the prez says that really, don’t blame him, he has no control over that behavior, then he is admitting that he’s failed in his role as a corporate overseer, which is what legally the board of directors is supposed to be about.

In the middle of this debate I have one of my occasional modest proposals. It does not address the deeper issues, which would entail leaders of academic medical and health centers not being on those corporate boards at all--but see my Modest Prediction at the end.

Whenever do-gooders like us complain about these conflicts of interest, apologists for the One Percent crowd claim that after all, these board relationships are very valuable for the university or the AMC or the health system. They expose the board to the presumably enlightened views of academic and health care leaders. They expose the leaders to important information about what’s happening on the corporate side, thereby stimulating productive university-industry partnerships for the future. So how could anyone be so narrow-minded as to object to these relationships?

Hence my modest proposal—demand that any academic or health care leader who serves on a corporate board do so without pay and at his/her own expense for travel and lodging. If their being on the board is so all-fired valuable to the academic or health institution, then let that board service be a part of the CEO’s job at that institution. Last I heard, none of these high rollers were being underpaid for their leadership roles. They have funds to cover their activities if they travel on university or hospital business, so why not regard board service under that category?

I would along with the modest proposal make a modest prediction. If you ceased paying these CEOs personally for their board service, commonly nowadays in the six-figure-per-year range, suddenly none of these CEOs would want to be on corporate boards any more. So much, if so, for all the wonderful intellectual advantages of board service and industry relationships.

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