related to clinical research and clinical research training in hopes of ensuring that they are not overlooked as the nation grapples with health care reform.

Conflicts of Interest

The committee recommends that the government, universities, research institutes, and industry develop appropriate guidelines and means to resolve conflicts of interest to encourage strong cooperation in clinical studies.

The committee believes strongly that the translation and application of advances in research to patient care require a strong partnership between research universities and medical centers and industry. Effective interdependent relationships between clinical investigators, their institutions, and industry are necessary for the United States to continue to lead the world in developing innovative therapies. Facilitating technology transfer by both parties with the support of the federal government is vitally important and deserves special attention. This will require new standards in the definition and resolution of conflicts of interest at all levels. Healthy relationships that encourage full cooperation can build on this interdependence and can be synergistic.

Preserving Academic Health Centers

The committee emphasizes that the federal government and third-party payers recognize the vital contributions that academic health centers (AHCs) make in medical education and clinical research to improve health care and recommends that they take appropriate action to reimburse AHCs according to their broad mission.

The committee acknowledges that the costs of health care in the nation's AHCs appear to exceed those of health care providers without a broader mission for teaching and research. Because of AHCs' commitment to research and teaching, these institutions frequently cannot compete on a pure cost basis with other providers, and payers must be made aware of their broad mission. The committee believes that there is a need to identify, isolate, and detach those costs unique to the AHCs that provide benefit to all stakeholders and to provide payment through a separate income stream funded by all payers. This in effect would provide parity so that AHCs could compete fairly in the provision of patient care on the basis of quality and price. Providing state-of-the-art care and



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