Industry and the profession of medicine: balancing appropriate relationships with the need for innovation.

Much has been made over the last few years about conflicts of interest in the health care community's relationships with industry members, including individual physicians, academic medical centers, and professional organizations. Not only has the Department of Justice (DOJ) been investigating questionable relationships, but House and Senate Oversight Committees have also weighed in on real and perceived conflicts. Most recently, the Physician Payments Sunshine Act of 2010 requires companies to begin recording any physician payments, including stock options, research grants, knickknacks, consulting fees, and travel to medical conferences that are worth more than ten dollars in 2012 and report them on March 31, 2013. To date, the American College of Cardiology (ACC) has developed and instituted one of the most stringent policies in the medical community to ensure that support from industry has no influence on any of its clinical documents. Furthermore, the need for the ACC's "Principles for Relationships with Industry," the organization's guide in nine key operational areas, are critical given that, when it comes to industry, properly managed partnerships are absolutely essential to maintaining scientific progress in cardiology and other specialties. The ACC relies on industry funding to advance cardiovascular research, as well as cardiovascular workforce training, practitioner diversity, medical education, and life-long learning. Without this funding, the ACC's ability to provide meaningful, unbiased education and to improve quality of care would be far more limited than that which is currently offered to its members and, ultimately, patients. Rather than restricting industry funding for such activities, the focus should instead be on transparency and actively and appropriately managing industry relationships. Ethical and appropriate partnerships with industry can prove beneficial in funding of education, research, and quality improvement activities. In addition, they are critical in the advancement of the quality of care for patients. The challenge is for medical societies to help the media, the public, and policymakers better understand the role of industry in promoting research, education, and innovation in medicine.