dermatology department endowments
TRANSCRIPT
J AM ACAD DERMATOL
VOLUME 63, NUMBER 4
Letters 719
to reflect commercial rather than clinical priorities.3
Without the cooperation of the few physicianopinion leaders in psoriasis, placebo-controlled orcomparator studies would be very difficult to com-plete. However, many opinion leaders’ potentialconflicts of interest may impede their willingness touse their influence to guide company-sponsoredresearch to best serve physicians’ and patients’interests.
The extent of potential conflict of interest amongopinion leaders is illustrated by the relationshipsof the 10 psoriasis experts who coauthored theAcademy guidelines for biologics to the threecompanies with biologic products for psoriasiswith highest sales (Amgen, Abbot, and Centocor).4
Each of the experts who contributed to recommen-dations concerning the use of these medicationsserved as an investigator for an average of 2.6 ofthese three companies. In all 26 instances, theseindividuals served as a consultant/advisory boardmember or speaker and investigator for that com-pany. Although these multiple relationships maynot be prohibited, they seem to conflict with themission of academic medicine and could bias thedesign of studies and the reporting of their resultstoward those favored by the commercial sponsors.5
With billions of dollars in sales and a small numberof opinion leaders in psoriasis, this result may notbe surprising, but it is disappointing as we mayhave lost an opportunity to shape the psoriasisresearch agenda to maximize patients’ rather thancorporate interests. After 7 years and despite com-pany commitments to evaluate the long term safetyof these expensive and highly profitable products,high quality long term safety data remainunavailable.
Robert S. Stern, MD
Department of Dermatology, Beth Israel DeaconessMedical Center, Harvard Medical School, Boston,Massachusetts
Funding sources: None.
Conflicts of interest: Dr Stern has served as aconsultant to divisions of Johnson and Johnsonother than Centocor concerning adverse reac-tions to medications not licensed or being devel-oped for psoriasis.
Correspondence to: Robert S. Stern, MD, Carl J.Herzog Professor of Dermatology, Beth IsraelDeaconess Medical Center, Harvard MedicalSchool Boston, 330 Brookline Ave, Boston, MA02215.
E-mail: [email protected]
REFERENCES
1. Sivanesan S, Gattu S, Hong J, Chavez-Frazier A, Bandow G,
Malick F, et al. Randomized, double-blind, placebo-controlled
evaluation of the efficacy of oral psoralen plus ultraviolet A for
the treatment of plaque type psoriasis using the Psoriasis Area
Severity Index score (improvement of 75% or greater) at 12
weeks. J Am Acad Dermatol 2009;61:793-8.
2. Dermatologic and Ophthalmic Drugs Advisory Committee.
Forty-ninth meeting transcript. March 20, 1998. p. 8-3.
3. Griffiths C, Strober B, van de Kerkhof P, Ho V, Fidelus-Gort R,
Yeilding N, et al. Comparison of ustekinumab and etanercept for
moderate-to-severe psoriasis. N Engl J Med 2010;362:118-28.
4. Gottlieb A, Korman N, Gordon K, Feldman S, Lebwohl M, Koo J,
et al. Guidelines of care for the management of psoriasis and
psoriatic arthritis. J Am Acad Dermatol 2008;58:851-64.
5. Lo B. Serving two masters—conflicts of interest in academic
medicine. N Engl J Med 2010;362:669-71.
doi:10.1016/j.jaad.2010.05.028
RESEARCH LETTERS
Dermatology department endowments
To the Editor: Securing funding for a dermatologydepartment/division is a critical task to enhance itsacademic missions. Numerous sources of capitalexist, but we believe that endowment building islargely underused. This may stem from a number offactors: (1) lack of fundraising knowledge, (2) time,energy, funds, and focus, and (3) the fact thatrestricted gifts may be difficult to manage.1
We used Survey Monkey to e-mail United StatesDepartment Chairs and Division Chiefs the survey.Institutional review board exemption was obtained.
Thirty-seven out of 125 departments responded,with nonrespondents being sent a second e-mail.
The poor response rate made it difficult to assess
statistical significance.Fifty-five percent of respondents had endow-
ments between $0 and $1 million, and 30% had
endowments ranging from $1 to $5 million (Table
I). Most of these endowments are for research and
education, with very few for clinical and commu-
nity service missions. This may signify that fund-
raising strategies are skewed, with undersolicitation
of patients and community businesses. The latter
Table I. Dermatology department and divisionendowments
Survey respondents
Endowment sizes Percent No.
$0 13.5 5\$100,000 10.8 4\$500,000 16.2 6\$1 million 10.8 4\$5 million 29.7 11[$5 million 18.9 7
Table II. Fundraising tactics
Internal investmentsStaff members devoted to endowment buildingExecutive support—donor meetingsRetreats/training sessions for staffFinancial investments (advertisements, direct mailings,
hosting events, Web development)Planned giving programInvestment and charity acceptance policiesProfessional investment management
External investmentsProfessional consultantsIntrainstitutional referral programsInvestment management
J AM ACAD DERMATOL
OCTOBER 2010
720 Letters
may be an excellent source for funding becausethey have incentives to invest, including commu-nity service, positive publicity, and communityinvestment.
We also found low use of the following: (1)fundraisers; (2) links on the department Web sitefor giving; (3) posters in the hospital or clinics; and(4) sending e-mails and direct mailings to previouspatients.
Other options for funding include staff membersdevoted to endowment development, donor meet-ings, and hiring outside consultants. Even here,minimal resources were invested.
Donor meetings, which increase endowments,were used somewhat, with 31% of respondentshaving zero to one meetings annually with previousdonors. Less than $5000 per year is spent by 65% ofthe departments for marketing. In contrast, oneprogram with endowments of more than $5 millionhired a full time development officer, held morethan five donor meetings annually, held more thanfive fundraisers per year, and spent approximately$30,000 per year on endowment building. Clearly,this is a significant amount of initial investment, andthe fear resulting from uncertainty regarding returnsis understandable. However, we must realize thatit is a heuristic error based on under appreciatingthe significant future wealth. Daniel Kahnemenexplicated this idea in his research on referencevalues, for which he won the 1998 Nobel Prize inEconomics.2
Our research shows that: (1) dermatology de-partments and divisions are underutilizing endow-ments as an income source, and (2) that currentstrategies to build endowments are limitedand rely mostly on passive faculty and alumnisupport.
Fundraising requires significant investment(Table II). These efforts, however, can result insignificant endowment funds.
A department or division should develop a givingappeal brochure, which can appear on their Web site
and be mailed annually. Once donors are identified,a development officer should be consulted to initiateone-on-one meetings to explore a donor’s passionsfor giving. In addition, we recommend having moredonor meetings, considering external consultants,and engaging patients and businesses as potentialdonors. Greater staff and faculty training awarenesson endowment building would also facilitatefundraising.
With future public support of departments anddivisions potentially diminished, endowments are anincreasingly important funding source for the aca-demic mission.
Harbir Singh, BA, Jeffrey J. Miller, MD, DavidMauger, PhD, and James G. Marks, Jr, MD
Department of Dermatology, Penn State Milton S.Hershey Medical Center, Hershey, Pennsylvania
Funding sources: None.
Conflicts of interest: None declared.
Correspondence to: Harbir Singh, BA, Departmentof Dermatology, Penn State Milton S. HersheyMedical Center, 500 University Dr, Box 309,Hershey, PA 17033.
E-mail: [email protected]
REFERENCES
1. Miree K. From theory to practice: three successful models to build
endowment. Available at: http://www.kathrynmireeandassociates.
com/PDF/Three%20Successful%20Models%20to%20Build%20
Endowment.pdf. Accessed February 21, 2010.
2. The Nobel Foundation. The Sveriges Riksbank Prize in Economic
Sciences in memory of Alfred Nobel 2002. Information for the
public. Available at: http://nobelprize.org/nobel_prizes/economics/
laureates//2002/public.html. Accessed September 9, 2009.
doi:10.1016/j.jaad.2009.10.039