Academic health experts are often regarded as impartial specialists not tainted by industry interests or political motives. But a new analysis suggests that perception isn’t entirely accurate for a significant minority of medical specialists.

Nearly one in 10 healthcare company board positions are held by top academics from the most renowned U.S. medical and research institutions, according to a study published in the British Medical Journal (BMJ). The findings raise questions about potential conflicts of interest not covered by national guidelines as well as the impartiality of academic medical research, the BMJ researchers said.

“There are potential benefits to having greater representation of the non-profit healthcare sector in the corporate board room, and academic institutions may directly benefit from their leaders, professors and trustees developing management skills and forging fundraising or research partnerships," explained the authors.

"However, these same director qualifications and connections can be the source of conflicting interests which have not been fully addressed by professional societies or academic institutions and deserve additional review, regulation, and in some cases, prohibition when conflicts cannot be reconciled."

Among the findings of the new study:

• 279 healthcare company directors were affiliated with 85 non-profit academic institutions, including 19 of the top 20 National Institute of Health-funded medical schools, and all 17 of the US News Honor Roll hospitals.
• These directors received "considerable" cash compensation totaling $54,995,786.
• Salaries often approached or surpassed typical academic clinical earnings, and on average they each received annual payments of $193,000 as well as significant stock options.
• Overall, 73 of the directors were chief executive officers, presidents, trustees, provosts, deans, and department chairs; 121 were professors and 85 were trustees.

Unlike consultants or academics who receive industry funding, individuals paid to serve as directors often oversee executive officers, and set major strategic initiatives and handle major financial decisions for which they are responsible.

The U.S. Physician Payments Sunshine Act requires that payments to physicians and academic medical centers by pharmaceutical and medical device companies be publicly reported. But the federal law does not mandate separate reporting of payments for serving as a company director.

For the BMJ study, researchers examined healthcare companies that specialize in pharmaceuticals, biotechnology, medical equipment, or healthcare services. Of the 442 companies with publicly accessible disclosures on boards of directors, 41 percent included at least one director with an academic affiliation.

The researchers declined to identify the directors with academic affiliations out of a desire to highlight the topic, rather than focus on individuals.

In an accompanying editorial, David Rothman of the Columbia College of Physicians and Surgeons said "no one seeks to demonize industry" because "academy-company cooperation is necessary for medical progress."

But he called the compensation sums "unsettling" and "although it may seem radical, excluding leaders from directorships is the only credible policy."

"Many ways exist for sharing knowledge without joining a board," he said, adding: "integrity must take precedence over individuals' compensation."