At a time of heightened scrutiny over Boston hospitals’ ties to private industry, the new leaders of three Harvard-affiliated medical centers have decided not to take paid corporate board positions as their predecessors did.
Nearly a year ago, Boston stood out nationally when a Globe survey found that six out of its seven teaching hospital chiefs held paid positions on health care company boards, some coming with cash and stock compensation worth millions. Among them was Dr. Elizabeth Nabel, then president of Brigham and Women’s Hospital, who resigned from the Moderna board after concerns over whether her work for the Cambridge biotechnology company created a conflict of interest with her day job.
Today, the number of Boston hospital heads moonlighting on corporate boards has dropped by half: The new chief executive of Boston Children’s Hospital resigned his position as a director of a pharmaceutical company this summer; and the new presidents at Brigham and Women’s and Massachusetts General Hospital — both appointed in August — said they do not plan to join boards of for-profit health care companies, at least for now.
They all cited the considerable responsibility of running a major hospital and other commitments to explain their reasoning, a departure from their predecessors, all of whom accepted board positions at health care companies.
“I see it as a very good sign that the new presidents at BWH and MGH do not have ties to industry and that the new Children’s CEO resigned his board position when he took that role,” said Dr. Nancy Keating, a Brigham internist who signed on to a petition by Harvard Medical School faculty last summer asking hospitals to prohibit the practice. “That said, these are just three data points, and I am reluctant to draw any firm conclusions. I think policy revisions would be a more certain solution to avoiding these potential conflicts of interest in the future.”
The Boston Globe Spotlight Team report in April included a survey that found Boston’s academic medical center chiefs moonlight on health care company boards far more than hospital leaders in other cities. Even in a city as vast as New York, none of the executives who ran 13 hospitals included in the Spotlight analysis were on corporate boards.
At one point, both Nabel and Dr. Laurie Glimcher, chief executive of Dana-Farber Cancer Institute, each sat on two boards.
Four months after becoming chief executive officer of Boston Children’s, Dr. Kevin Churchwell resigned from the board of Cyclerion Therapeutics in August. According to company filings, the Cambridge biotech company paid Churchwell more than $141,000 in cash and stock in 2019 and $73,000 last year, during which time Churchwell was the hospital’s president.
His predecessor, Sandra Fenwick, remains on the board of Teladoc Health, formerly Livongo, a position that vastly supplemented her $2.7 million yearly compensation when she was Children’s chief executive. Teladoc paid her cash and stock worth more than $1 million in one year alone.
Churchwell declined a request for an interview, but a Children’s spokesperson said in an e-mail that he did not step down because of a change in hospital policy. “He continues to evaluate all of his outside commitments given his new responsibilities as CEO and new requests for engagement in community and academic activities,” said Kristen Dattoli.
Dr. Robert Higgins, recently hired as president of Brigham and Women’s to replace Nabel, declined a request for an interview. But he said in an e-mail that he has “prioritized my research and academic interests, supported professional societies and organizations, and focused on mentoring and attracting more underrepresented minorities to medicine and health care leadership roles. I have found this work, alongside the care of patients and administrative leadership, to be both professionally and personally fulfilling and also a full-time commitment.”
Dr. David Brown, the new president of Mass. General, said in an e-mail that for the foreseeable future he is “really busy settling into and executing on a job that has round the clock leadership responsibilities at a depth and breadth that eclipses anything I have led in the past. I can’t imagine taking on any additional external professional responsibilities, even ones that might broaden my perspective in some useful or important way,’’ he said.
It’s unclear if the recent drop in board work signals that hospital trustees plan to tighten policies, or represents unrelated personal decisions by new leaders. But there’s no doubt that top hospital executives who sit on boards face more questions and dissent not only from the public, but from their own staff.
More than 100 physicians, researchers, residents, and medical students from an array of specialties signed a petition in July calling for the hospitals and Harvard Medical School to prohibit top executives from working on corporate boards. The practice, they argued, can hurt an institution’s reputation and erode public trust when the interests of a hospital and its patients collide with those of the for-profit company for which a hospital leader also works.
The medical school and Mass General Brigham, the parent organization of the two hospitals, are undertaking separate in-depth reviews of their policies. But the process has dragged on for months at both organizations without a resolution. The subject has long been contentious among the city’s medical leadership with periods of tightening, and loosening, the rules.
A conflict of interest committee at Harvard Medical School recently made recommendations to the dean, Dr. George Daley, but he declined to release them. The medical school makes rules for its faculty — most Harvard-affiliated hospital chiefs are faculty members — but does not dictate policy to the hospitals themselves, which largely function independently. If a hospital leader is a faculty member, the person must comply with both the medical school and hospital rules.
Dr. Carolyn Becker, a Brigham endocrinologist and coauthor of the petition, said the shrinking number of hospital chiefs on boards is encouraging, but not enough. She said a written policy change is needed.
“Why even leave the opportunity open for things to slide back again in a few years or if other opportunities are offered to these people or if they change their minds?’’ she said.
Becker said the petition has gotten no direct response from the medical school or the hospitals “other than we’re working on it.’’
Medical school and hospital officials have declined the Globe’s request for information on their deliberations.
At Tufts Medical Center and Boston Medical Center, which are not affiliated with Harvard, hospital chiefs also sit on outside boards. A spokeswoman for Tufts told the Globe this month that its chief executive, Dr. Michael Tarnoff, continues to serve on the board of AngioDynamics, a medical device company. However, Tarnoff donates his compensation to a nonprofit organization — a school for orphans in Africa — for which he also serves as a director.
Hospital trustees have often defended allowing top executives to work for outside health care companies, saying these directorships increase collaboration with the critical bioscience sector that produces important drugs and devices. The risk of conflicting interests, they assert, can be avoided with proper safeguards, such as prohibiting a hospital president from participating in discussions about conducting clinical trials with a company.
But critics of this practice say the measures are never foolproof, and do not address the potential reputational damage to a hospital or mitigate the considerable time and energy hospital leaders can spend on these outside jobs. Sitting on two boards, Glimcher, and previously Nabel, have been expected to attend between 30 and 40 meetings a year.
Dr. Jack Meyer, a retired Brigham radiologist and an emeritus professor at Harvard Medical School, had paused his donations to the Brigham over this issue and signed on to the petition. Meyer said he would not restart philanthropic giving based only on the current president’s personal decision and won’t until he sees new prohibitions in writing.
Liz Kowalczyk can be reached at firstname.lastname@example.org.