Australian researchers have found extensive financial relationships between the leaders of US medical associations and industry.

A new study has found that up to 80 per cent of the US-based medical doctors who lead influential professional medical associations have financial relationships with industry.

During 2017-19, leaders of 10 influential groups received almost US$130 million from the industry.

But there was considerable variation among the payments to leaders of the associations. Median amounts ranged from US$212 for leaders of the American Psychiatric Association to US$518,000 for the American Society of Clinical Oncology.

The largest research payments flowed to leaders of the American Society of Clinical Oncology (US$54 million) and the American College of Cardiology (US$21 million).

The largest general payments - which can include fees for consultancy, speaking, royalties and hospitality - were given to leaders of the North American Spine Society (US$9.5 million) and the Orthopaedic Trauma Association (US$4.7 million).

“Our study’s novel findings of enormous variation in the extent of these ties suggest that for some groups such independence will require time and major reform, whereas for others it will be quick and relatively easy,” the researchers conclude.

“These powerful doctor’s groups have enormous influence in the US and globally, including over the definitions of disease which determine who’s healthy and who’s sick,” says lead author Dr Ray Moynihan, Assistant Professor at Bond University in Australia, who researches the problem of overdiagnosis.

“It’s basic common sense that these leaders should be free from financial ties to companies which stand to gain enormously from the work of these medical associations” he says.

The researchers propose several actions, such as each association reviewing present conflicts and altering recruitment processes “to yield balanced and diverse groups of physician leaders largely free from financial conflicts of interest.”

They also call for greater reliance on resources like the Sunshine Act and Open Payments to help eliminate the need for the traditional ‘honour system’ of financial self-disclosure, which they say is ineffective and inaccurate at best.

“These steps could mitigate or even eliminate the overwhelming presence of financial conflicts of interest among medical societies and associations,” they write.

“This would protect these groups from producing biased documents or policies, which in turn would protect all physicians and the patients they treat.”

The study is accessible here.