The American Medical Association acted to restore its credibility last week by pledging not to endorse consumer products and launching an independent inquiry of the Sunbeam Corp. licensing deal.
The AMA's 475-member House of Delegates, meeting for the first time since the Sunbeam contract was signed in August, strove to end the controversy.
Delegates thanked the 14-member board of trustees for "swift and decisive action" following the Sunbeam deal and commended a demoralized AMA staff, which saw the departures of four top executives because of the uproar.
They also threw their support behind the board's selection of a nonphysician, Chief Operating Officer Lynn Jensen, as acting executive vice president.
Yet many were troubled by the board's equivocation on consumer product endorsements. In a striking show of independence, the House, which met in Dallas for its interim annual meeting, amended the board's proposed principles on corporate relationships to ban all consumer product endorsements. The board had proposed that such endorsements be allowed with board approval.
An ad-hoc committee of physicians will investigate whether there was prior knowledge or approval of the Sunbeam contract by trustees, particularly current Chair Thomas Reardon, M.D., and Nancy Dickey, M.D., who was chair a few weeks before the contract was signed. Dickey is now a trustee.
The contract gave Sunbeam the right to put the AMA's seal on all its 151 Health at Home products. The board decided to rescind the contract in September, which prompted the Delray Beach, Fla.-based appliancemaker to sue.
Some members felt the likelihood of further disclosures was remote, and an investigation would only drag out the affair. "Enough is enough," said one North Carolina delegate.
Others believed a House-run investigation was the only way to restore board credibility.
Some delegates were dissatisfied with a board-commissioned report prepared by Chicago law firm Sidley & Austin. Delegates were allowed to read the report if they signed a confidentiality agreement.
"The report was geared to look at staff," not trustees, said delegate Carl Restivo Jr., M.D., president of the Medical Society of New Jersey. "We in New Jersey would have been happier if the report was done by a firm that didn't have a longstanding relationship with the AMA."
In the end, the House stopped short of drastic measures, such as requiring trustees to disclose their votes in the future.
The New Jersey delegation withdrew its resolution calling for Reardon to resign. It was appeased in part by the board's announcement that it would not name Reardon or any other current trustee or officer to the position of executive vice president.
"Obviously, I feel better," Reardon said at a midweek news conference following several key votes. "My shirt is still white."
In a committee hearing on the first day of the interim meeting in Dallas, more than 40 delegates spoke about Sunbeam. One person dubbed it "Sungate."
Arnold Relman, M.D., former editor-in-chief of the New England Journal of Medicine, called on the AMA to end commercial endorsements and marketing. "The good name and the integrity of the AMA are far more important than any contribution to nondues income such deals might provide," Relman said.
In an unusual move, the editor of the Journal of the American Medical Association, George Lunberg, M.D., spoke to the House. He said the AMA "must not descend" into the endorsement business and called for refocusing on standard-setting, advocacy, communications and membership.
Delegates hired a consulting firm to assist an ad hoc committee in studying structure and governance. Also launched was a council to address declining membership, which became a rallying cry for nearly every topic on the agenda.
Jensen, 52, an economist and 23-year AMA veteran, will remain executive vice president until a permanent replacement is found for P. John Seward, M.D., who resigned Dec. 4. Reardon said the search will take about four months.
The board asked past presidents Alan Nelson, M.D., Robert McAfee, M.D., and Lonnie Bristow, M.D., to consider the interim job, according to sources. All declined. Nelson is currently executive vice president of the American Society of Internal Medicine.
Jensen is believed to be the first nonphysician to serve in the role of AMA chief executive officer. AMA bylaws give preference to a physician in the role, and the board will undoubtedly seek a physician as the permanent replacement. However, Reardon hinted that it might consider a nondoctor.
"I think the search committee is trying to decide whether (to) have a physician or nonphysician," said McAfee, a retired surgeon who was on the last search committee for an executive vice president. "I think there's been a shift to have the executive vice president be a good manager and not necessarily be the visible spokesperson for the organization."