Conflict of Interest Disclosure

Waiver for Disclosed Conflict of Interest: Michael Dowling, MSW

In accordance with Section 15 of the Federal Advisory Committee Act, the “Academy shall make its best efforts to ensure that no individual appointed to serve on [a] committee has a conflict of interest that is relevant to the functions to be performed, unless such conflict is promptly and publicly disclosed and the Academy determines that the conflict is unavoidable.” A conflict of interest refers to an interest, ordinarily financial, of an individual that could be directly affected by the work of the committee. As specified in the Academy's policy and procedures (http://www.nationalacademies.org/coi/index.html), an objective determination is made for each provisionally appointed committee member whether or not a conflict of interest exists given the facts of the individual's employment and the task being undertaken by the committee. A determination of a conflict of interest for an individual is not an assessment of that individual's actual behavior or character or ability to act objectively despite the conflicting interest.

We have concluded that for this committee to accomplish the tasks for which it was established, its membership must include, among others, at least one person who has current experience in the management of a large community hospital system that provides graduate medical education (GME) under current funding constraints and has developed new medical education capacity. To meet the need for this expertise and experience, Michael Dowling is proposed for appointment to the committee even though we have concluded that he has a conflict of interest because he is the president and chief executive officer of Northshore-LIJ Health System, which receives federal and state GME funding.

As described in his biographical summary, Mr. Dowling has long experience in the operations of the Northshore-LIJ Health System. The large 15 hospital health system includes four teaching hospitals and provides an integrated health system environment focused on quality for 110 residency and fellowship programs. He also served as a senior vice-president for Empire Blue Cross Blue Shield and recently as the co-chair of the NY State Medicaid Re-design Team. We believe that Mr. Dowling can serve effectively as a member of the committee and that the committee can produce an objective report, taking into account the composition of the committee, the work to be performed, and the procedures to be followed in completing the work.

We have not identified another individual who is available to serve, with an equivalent combination of practical experience and expertise in managing a broad array of facilities with his breadth of knowledge of financing and medical education along the continuum from medical school to graduate medical education programs who does not have a similar conflict of interest. Therefore, we have concluded that this potential conflict is unavoidable.

Waiver for Disclosed Conflict of Interest: Glenn D. Steele, Jr., M.D., Ph.D.

In accordance with Section 15 of the Federal Advisory Committee Act, the “Academy shall make its best efforts to ensure that no individual appointed to serve on [a] committee has a conflict of interest that is relevant to the functions to be performed, unless such conflict is promptly and publicly disclosed and the Academy determines that the conflict is unavoidable.” A conflict of interest refers to an interest, ordinarily financial, of an individual that could be directly affected by the work of the committee. As specified in the Academy's policy and procedures (http://www.nationalacademies.org/coi/index.html), an objective determination is made for each provisionally appointed committee member whether or not a conflict of interest exists given the facts of the individual's employment and the task being undertaken by the committee. A determination of a conflict of interest for an individual is not an assessment of that individual's actual behavior or character or ability to act objectively despite the conflicting interest.

We have concluded that for this committee to accomplish the tasks for which it was established, its membership must include, among others, at least one person who has first-hand experience in managing the operations of an integrated health system that is engaged in graduate medical education, and is knowledgeable of the training needs of physicians preparing for both clinical practice and research. To meet the need for this expertise and experience, Glenn Steele is proposed for appointment to the committee even though we have concluded that he has a conflict of interest because he is the president and chief executive officer of the Geisinger Health System, which receives federal and state funding for graduate medical education (GME).

As described in Dr. Steele’s biographical summary, Geisinger is an integrated health services organization widely recognized for its innovative use of the electronic health record, and the development and implementation of innovative care models including an advanced medical home model. The system serves more than 2.6 million people residing in 44 counties in central and northeastern Pennsylvania. Dr. Steele has oversight for the day-to-day operations of this health system that includes the training of residents and fellows. Specifically, the health system provides training for 16 types of medical residencies (including both allopathic and osteopathic programs in surgery) and 22 types of fellowships.

Previously, he served as Richard T. Crane Professor in the Department of Surgery, Vice President for Medical Affairs, and Dean of the Division of Biological Sciences and the Pritzker School of Medicine at the University of Chicago. Prior to that, he was the William V. McDermott Professor of Surgery at Harvard Medical School, President and Chief Executive Officer of Deaconess Professional Practice Group, and Chairman of the Department of Surgery at New England Deaconess Hospital. Dr. Steele is dually trained as a surgeon and a laboratory scientist having both a medical degree and a Ph.D. in microbiology/immunology. We believe that Dr. Steele can serve effectively as a member of the committee and that the committee can produce an objective report, taking into account the composition of the committee, the work to be performed, and the procedures to be followed in completing the work.

We have not identified another individual with an equivalent combination of practical experience and expertise in the hands-on practice of clinical medicine, research, and administration of innovative practice settings that train residents and fellows who does not have a similar conflict of interest. Therefore, we have concluded that this potential conflict is unavoidable.

Waiver for Disclosed Conflict of Interest: Debra Weinstein, M.D.

In accordance with Section 15 of the Federal Advisory Committee Act, the “Academy shall make its best efforts to ensure that no individual appointed to serve on [a] committee has a conflict of interest that is relevant to the functions to be performed, unless such conflict is promptly and publicly disclosed and the Academy determines that the conflict is unavoidable.” A conflict of interest refers to an interest, ordinarily financial, of an individual that could be directly affected by the work of the committee. As specified in the Academy's policy and procedures (http://www.nationalacademies.org/coi/index.html), an objective determination is made for each provisionally appointed committee member whether or not a conflict of interest exists given the facts of the individual's employment and the task being undertaken by the committee. A determination of a conflict of interest for an individual is not an assessment of that individual's actual behavior or character or ability to act objectively despite the conflicting interest.

We have concluded that for this committee to accomplish the tasks for which it was established, its membership must include, among others, at least one person who has current, first-hand experience directing residency and fellowship training programs across a broad spectrum of disciplines within an academic health center. To meet the need for this expertise and experience, Debra Weinstein is proposed for appointment to the committee even though we have concluded that she has a conflict of interest because she has direct oversight for training programs as the vice president for graduate medical education (GME) at Partners Health System, which receives federal GME funding.

As described in her biographical summary, Dr. Weinstein has numerous years of experience overseeing more than 200 graduate medical education programs for approximately 2000 residents and fellows to assure that they meet accreditation standards. Dr. Weinstein is an Assistant Professor of Medicine at Harvard Medical School and a practicing gastroenterologist at Massachusetts General Hospital, within the Partners Health System. Dr. Weinstein served on the Board of Directors of the Accreditation Council for Graduate Medical Education, was a past chair of the Association of American Medical Colleges' Group on Resident Affairs, has led or served on several national task forces related to graduate medical education, and recently chaired a Macy Foundation conference on GME reform. We believe that Dr. Weinstein can serve effectively as a member of the committee and that the committee can produce an objective report, taking into account the composition of the committee, the work to be performed, and the procedures to be followed in completing the work.

We have not identified another individual with an equivalent combination of current practical experience and expertise in administering graduate medical education at an institutional level and familiarity with accreditation practices who does not have a similar conflict of interest. Therefore, we have concluded that this potential conflict is unavoidable.