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USF medical office spending queried

Two employees of the University of South Florida College of Medicine enjoyed four days in the oceanfront resort of Cancun, Mexico, last summer.

The purpose of the trip? To check out hotels that might be suitable for USF-sponsored seminars for doctors. The cost to the state: $991.40.

That trip is among dozens of examples of questionable spending by USF's Office of Continuing Medical Education, according to an audit released Tuesday. The office arranges programs to keep doctors abreast of the latest medical developments.

The audit, prompted by stories in the Times in the spring, also found possible double dipping by USF employees, a conflict of interest involving the office's top two officials and "numerous instances of non-compliance with university policies, state regulations and (continuing education) guidelines."

Moreover, the university auditors said, pharmaceutical companies have had too much influence on some continuing education programs, often selecting speakers and topics.

Dr. Marvin Dunn, dean of USF's medical school, said he was surprised by the office's apparent "insensitivity to university issues." He promised a thorough review of travel for the past two years and said employees might have to reimburse the state.

"We'll do a followup analysis of the travel," Dunn said, "The auditors only looked at a small portion of it. We're going to systematically go through everything. If anyone has been paid twice for anything, we'll seek reimbursement."

Dunn said he has no evidence that anyone deliberately double-billed or profited from sloppy record keeping. "But we need to clear the air," he said.

Dunn requested the audit after the Times stories raised questions about the influence of drug companies that finance much of the continuing education programs. The companies see the courses as a way to tell doctors about their products.

At times, however, the process of informing the doctors turns into a not-so-subtle pitch to sell particular brands of drugs.

The audit looked at eight continuing education programs held between July 1991 and June 1992, and found that in four of those, drug companies "appeared to have influenced the planning of the program's content and the selection of the speakers."

Two of those programs, the auditors wrote, were simply to train speakers "who routinely speak at seminars sponsored by the pharmaceutical (companies)." One company, Ciba-Geigy, also determined the topic of the programs, the auditors noted _ a discussion of the drug Lotensin, which the company manufactures.

Among the audit's other findings:

Official, pre-numbered receipts were not issued for registration fees paid on-site at some seminars, making it difficult, if not impossible, to account for that money.

Dr. Pierre Bouis, associate dean in charge of the continuing education office, directed business to the husband of Joan Runnels, who works for Bouis as coordinator of the office. Without adequate approval, Bouis hired the husband's company, Meeting Needs International, to help process paperwork and paid the company $11,085. Bouis told the auditors he didn't know anyone else who would have done the work.

Forms to justify travel were not completed for 22 of the 36 trips reviewed. Auditors also found that Runnels had approved Bouis' travel and that Bouis had approved hers, a violation of university policy that requires a supervisor to approve travel.

Bouis did not return phone calls. Runnels was reported to be on vacation.

Employees of the continuing education office sometimes claimed reimbursement for lodging and food at seminars, while those things were provided by the pharmaceutical companies footing the bills.

Travel reimbursement requests did not contain complete and accurate information. "We were, therefore, unable to determine if duplicate expenditures were reimbursed" from different accounts, the auditors wrote.

Dunn, dean of the medical school, said Tuesday he is confident "Bouis will implement necessary changes" in the continuing education office.

Dunn also said he will form three task groups to deal with the problems identified in the audit.

The first will oversee changes in the office and will oversee and verify daily business transactions.

The second will oversee "the full and complete" implementation of tougher guidelines of the Accreditation Council on Continuing Medical Education.

The third, Dunn said, will study ways to reorganize the entire program.