On Thursday, Dr. José Baselga resigned from his position as chief medical officer at Memorial Sloan Kettering Cancer Center. Earlier this month, ProPublica and The New York Times revealed that he’d received millions of dollars from drug and device companies whose fortunes he stood to affect. He also sat on the board of at least six companies, where his fiduciary responsibility to them might conflict with his obligations to the cancer center. Most of his outside income was not disclosed to the journals in which he published, in violation of their requirements.

Although his case is extreme, these kinds of conflicts of interest are virtually universal in the upper levels of academic medicine.

I was an editor of The New England Journal of Medicine for over two decades, and was there in 1984 when we became the first major medical journal to institute a policy that required authors of research articles to disclose all financial ties to companies that could be affected by their research. We had become aware that academic researchers were receiving large payments from drug companies and that it was distorting their work. For example, I once phoned the senior author of a paper submitted to us to ask why he had neglected to mention the side effects of a potent new drug he was testing. Without any apparent embarrassment, he said that the sponsor wouldn’t let him. We didn’t publish the paper, but another journal did.

In order to get prescription drugs approved by the Food and Drug Administration, companies must conduct clinical trials to show that the drugs are safe and effective. But drug companies don’t have direct access to human subjects, so they’ve always contracted with academic researchers to conduct the trials on patients in teaching hospitals and clinics. Traditionally, they gave grants to the institutions for interested researchers to test their drugs, then waited for the results and hoped that their products looked good. The grants were at arm’s length; the companies didn’t design or analyze the studies, they didn’t own the data, and they certainly didn’t write the papers or control publication.