Cleveland Clinic Magazine is a biannual publication of Cleveland Clinic.

Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit, multispecialty academic medical center that integrates clinical and hospital care with research and education. Cleveland Clinic was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation.

Today, Cleveland Clinic is one of the largest and most respected hospitals in the country.

At Cleveland Clinic, we provide our patients with cutting-edge advancements in coronary medicine, an impeccable surgical record and a world-renowned research team.

Cover Story: 10 DISEASE DETECTIVES

Whether you know it or not–if you’ve ever had a blood test, a Pap smear or a biopsy–a pathologist has helped you out. These behind-the-scene physicians are integral to screening, diagnosing and developing protections against disease, infection and immunorejection.

Although patients never get to meet them, you wouldn’t want to have medical care without one.

Download Cleveland Clinic Magazine, Winter 2007

PDF format, 1.48MB, 48Pages.

16 GOING “BLOODLESS”
When James Bell emerged from five hours of open-heart surgery, he had lost only about a cup of blood–not much for a major surgery. What’s also remarkable is that Bell’s surgery involved no blood transfusions at all. That’s because new technologies– along with a growing awareness that blood conservation and minimizing or eliminating transfusions benefit everyone–are changing the way surgery is performed today.

24 TRYING A TRIAL
Clinical trials test the safety and effectiveness of drugs, medical procedures or devices on people. In the United States, approximately 12,000 clinical trials take place annually. The time will come when you or a loved one will consider volunteering for a clinical trial. What’s it like to participate? How are volunteers protected? What if the trial ends badly? Here’s an inside look at what it means to be on the testing edge of medicine.

Visit Cleveland Clinic Official Website

U.S.News & World Report has ranked Cleveland Clinic #1 in America for heart care, 13 years in a row.

Innovation Management and Trust

Cleveland Clinic is proud to be an innovative and entrepreneurial institution. We have pioneered new ideas and inventions for more than 85 years. As pioneers, we are often among the first to face new challenges and changing conditions. Such has been the case with conflict of interest. Cleveland Clinic has been a leader in the national discussion of confl ict of interest as it relates to medical discovery.

We are setting standards that will maintain the highest level of integrity, without affecting the pace of innovation that is so critical to the future of patient care.

In September 2006, Cleveland Clinic hosted the first National Dialogue on Confl ict of Interest and Innovation Management Summit. The dialogue included recognized leaders in academic biomedical research, industry, government, medical research publishing, bioethics and professional medical organizations. Participants came away with a new appreciation for the hazards and complexity of these many-sided issues.

Conflict of interest arises most often around innovation and entrepreneurial activity. In many cases, innovation has become synonymous with entrepreneurial activity. Just last year, the Council on Competitiveness, in its call for action titled Innovate or Abdicate, said, “America’s challenge is to unleash its innovation capacity to drive productivity, standard of living and leadership of global markets. For the past 25 years, we have optimized our organizations for efficiency and quality. Over the next quarter of a century, we must optimize our entire society for innovation.”

Several factors have increasingly driven confl ict of interest discussions. New knowledge is one such factor. The
total amount of new knowledge doubles every two-and-ahalf years. This intellectual capital increases the potential for innovation. The enhanced potential for the development of new products and services has attracted increased corporate interest. The fact that healthcare is 16 percent of the GDP and 25 percent of all federal expenditures also has captured corporate attention.

The 1980 Bayh-Dole Act is often seen as a major conflict of interest accelerator. It was passed to encourage universities to commercialize their intellectual capital. The act has contributed to breakthroughs in computing, nanotechnology, communication, genomics and minimally invasive therapies, stimulating an increasingly entrepreneurial spirit in the academic healthcare community. This entrepreneurial activity has led to the formulation of an increasingly sophisticated set of rules governing confl ict of interest.

Increased scrutiny in this rapidly changing environment has led some to conclude that even the appearance of confl ict of interest is detrimental and should be avoided at all cost. It has caused others to conclude that any economic incentive is corruptive of parties involved in innovation, and that entrepreneurial activities may result in patient harm. There is no question that the crossroads of innovation and commerce harbor forces that are complex, confl icting and potentially corrupting. However, there are management tools that can be deployed at these crossroads–simple, complementary and constructive tools–including clearly documented and uniformly enforced standards for incentives, disclosures, transparency and accountability, as well as standard operating procedures for the full, factual and fair adjudication of non-compliance.

At Cleveland Clinic, we are continually reviewing and revising our conflict of interest policies to assure the continuing integrity of our patient care mission. We hope to accelerate the development of constructive policy that will continue to inspire, incentivize and support the work of our most gifted physicians, scientists and others, and maintain the highest standards of scientifi c ethics and patient care.

We find it useful to frame these issues as innovation management rather than confl ict of interest. Managing innovation is an essential, fundamental and comprehensive activity. Managing conflicts is a necessary and important part of the larger innovation management process.

Today, innovation is imperative. We cannot become what we must in patient care and scientific discovery if we fail to innovate. Nor can we achieve what we must without the trust of our patients. I am confident that with successful innovation management, we can retain that trust and continue our role as pioneers of new treatments and explorers of new medical horizons.

Delos M. Cosgrove, M.D.
CEO and President

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