The study notes that in 2008, "no policy" was the most prevalent finding in all but one CCOI area. By 2011, almost all schools had made strides, and the number of schools with no policies dropped sharply from more than a quarter in 2008 to less than 2% in 2011.
Policies in the "moderate" range more than doubled, from 14% to 30%. However, the proportion of schools with strong policies in eight or more areas barely increased, from 1% in 2008 to 4% in 2011. Less-than-stringent policies remained typical for all areas except ghostwriting. Eighty-four percent of schools had substandard policies in seven or more areas.
Chimonas says her study doesn't ask why the schools aren't moving more quickly on conflict of interest policies, but she speculated on the reasons.
"Maybe there is faculty resistance," she says. "Physicians might like getting the gifts and the payments. So it could be a difficult thing for schools to move forward and implement these things. It could also be institutional resistance. Medical schools have a lot of other things on their plate that are maybe more urgent on a day-to-day basis. So maybe this isn't a priority for them yet."
"There are many reasons we could think of for why progress isn't being made more quickly. The point we can agree on is that more progress needs to be made and we have to figure out how to help or encourage schools to move forward from this point on."