title: Health industry practices that create conflicts of interest: a policy proposal for academic medical centers.
abstract: Conflicts of interest between physicians' commitment to patient care and the desire of pharmaceutical companies and their representatives to sell their products pose challenges to the principles of medical professionalism. These conflicts occur when physicians have motives or are in situations for which reasonable observers could conclude that the moral requirements of the physician's roles are or will be compromised. Although physician groups, the manufacturers, and the federal government have instituted self-regulation of marketing, research in the psychology and social science of gift receipt and giving indicates that current controls will not satisfactorily protect the interests of patients. More stringent regulation is necessary, including the elimination or modification of common practices related to small gifts, pharmaceutical samples, continuing medical education, funds for physician travel, speakers bureaus, ghostwriting, and consulting and research contracts. We propose a policy under which academic medical centers would take the lead in eliminating the conflicts of interest that still characterize the relationship between physicians and the health care industry.
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA. tabrennan@partners.org
authors.forename: Troyen A
authors.initials: TA
authors.lastname: Brennan
authors.forename: David J
authors.initials: DJ
authors.lastname: Rothman
authors.forename: Linda
authors.initials: L
authors.lastname: Blank
authors.forename: David
authors.initials: D
authors.lastname: Blumenthal
authors.forename: Susan C
authors.initials: SC
authors.lastname: Chimonas
authors.forename: Jordan J
authors.initials: JJ
authors.lastname: Cohen
authors.forename: Janlori
authors.initials: J
authors.lastname: Goldman
authors.forename: Jerome P
authors.initials: JP
authors.lastname: Kassirer
authors.forename: Harry
authors.initials: H
authors.lastname: Kimball
authors.forename: James
authors.initials: J
authors.lastname: Naughton
authors.forename: Neil
authors.initials: N
authors.lastname: Smelser
mesh_terms: D000046:Academic Medical Centers / Q000941:ethics* / Q000592:standards; D016265:Conflict of Interest; D004345:Drug Industry / Q000941:ethics* / Q000592:standards; D004991:Ethics, Institutional; D004992:Ethics, Medical; D037921:Gift Giving / Q000941:ethics*; D019981:Health Care Sector / Q000941:ethics* / Q000592:standards; D006801:Humans; D007373:Interinstitutional Relations; D007400:Interprofessional Relations / Q000941:ethics*; D008505:Medical Staff, Hospital / Q000941:ethics / Q000592:standards; D011050:Policy Making; D011640:Public Policy; D014481:United States