“You scratch my back; I’ll scratch yours.” Human beings have operated on this principle even before the dawn of civilization.
This practice can work for mutual benefit, but it also causes problems. When people in power make decisions based on favors, the public may suffer.
That’s why there are strict conflict of interest rules for government employees. We don’t want public servants profiting from secret deals. Referees, stock analysts and journalists are also supposed to maintain independence so that they can remain objective.
Why wouldn’t we expect the same standards to apply to doctors and medical researchers? If anything, our health professionals should be held to even higher standards than politicians. After all, doctors’ decisions affect life and death.
For far too long, however, industries that make drugs and medical devices have been influencing research and clinical practice. That’s the conclusion of a report recently issued by the prestigious Institute of Medicine (IOM). This organization provides independent, objective and evidence-based advice to health professionals, policy makers and the public.
Over the decades, pharmaceutical manufacturers have provided meals both plain and fancy as well as junkets and funding for continuing medical education conferences in desirable resort locations. Some of these perks have been discontinued, but many physicians still benefit from meals or money provided by pharmaceutical, biotech and device companies.
The Institute of Medicine report calls for total transparency of conflicts of interest. Consulting arrangements between physicians and drug companies may often go undisclosed. They can involve huge amounts of money.
For example, renowned child psychiatrist Joseph Biederman, MD, has been criticized for accepting more than $1 million from drug companies without reporting all these funds to his employer, Harvard University. Because he was influential in promoting the use of powerful antipsychotic medicines to children, his ties to the makers of these medications has stirred up controversy both at Harvard and on Capitol Hill.
He’s not the only one. Other prominent researchers have also received millions of dollars they have failed to fully disclose.
Whether it’s a free lunch, a trip to Hawaii or a fat consulting fee, most health professionals deny that such favors influence their judgment. There is, however, considerable evidence that gifts do make a difference (Journal of the American Medical Association, Jan 19, 2000).
The IOM recommends that doctors and researchers not accept gifts of any amount from drug companies or device manufacturers. That means no more lunches, pens, pads or coffee mugs. Any consulting or speaker’s fees should be fully disclosed. Doctors who have financial conflicts of interest should not be allowed to test new therapies on patients.
When an umpire calls a pitch either a strike or a ball, we expect him to be totally objective and as accurate as humanly possible. We deserve at least as much from our health professionals. Conflicts of interest jeopardize public trust in health care and should be eliminated.
