Facing Conflicts: The Battle between Medicine and Industry

It is hard to avoid noticing that few, if any, of the regulatory measures currently in development are directed by physicians or the medical profession.

Conclusion

There is little doubt that recent high-profile stories revealing the financial relationships between physicians and industry have served as a wake-up call to both medicine and the public at large. Abolishing interaction between physicians and industry might seem to be a simple way to resolve the problem of conflict of interest. But such an approach is not realistic and could short-sightedly limit the benefits of physician interaction with industry. Our challenge is to balance the potential synergies that these interactions can enable, while maintaining the professionalism and independence that is essential to the practice of medicine. Complete disclosure of financial relationships serves as a starting point. Disclosure, however, is not enough. It is the steps taken after disclosure that remain most crucial. Once financial relationships are openly declared, the question remains, What is the appropriate mechanism to adopt in order to minimize the potential for bias? This question should be seriously considered by organized medicine if we intend to remain a viable part of this conversation. In the end, the answer should be simple: The real key to success as we move forward is vigilance on the part of medicine to act selflessly as the advocate for the patient.

References

1. Samson K. Senate probe seeks industry payment data on individual academic researchers. Ann Neurol 2008;64(6): A7-9.
2. www.nytimes.com/2008/10/04/health/policy/04drug.html?_r=1&oref=slogin .
3. www.nytimes.com/2008/06/08/us/08conflict.html .
4. For example, see http://hcrenewal.blogspot.com/2008/10/thoughts-on-charles-nemeroffs-not-so.html and http://blogs.wsj.com/health/woo8/12/23/under-grassleys-glare-emorys-nemeroff-gives-up-psychiatry-chair .
5. Opar A. Medical students protest perks from drug companies. Nat Med 2006; 12(10):1104.
6. Fitz MM, Homan D, Reddy S, Griffith CH 3rd, Baker E, Simpson KP. The hidden curriculum: medical students’ changing opinions toward the pharmaceutical industry. Acad Med 2007;82(10 Suppl):S1-3.
7. Campbell EG, Gruen RL, Mountford J, Miller LG, Cleary PD, Blumenthal D. A national survey of physician-industry relationships. N Engl J Med 2007;356: 1742-50.
8. http://online.wsj.com/article/SB123000405102929417.html .
9. Liesegang TJ. Commercialism, loss of professionalism, and the effect on journals. Arch Ophthalmol 2008;126(9): 1292-5.
10. Lichter PR. Debunking the myths in physician-industry conflicts of interest. Am J Ophthalmol 2008;146(2):159-71.
11. Dana J, Loewenstein G. A social science perspective on gifts to physicians from industry. JAMA 2003;290(2): 252-5.
12. Orlowski J, Wateska L. The effects of pharmaceutical firm enticements on physician prescribing patterns. Chest 1992; 102:270-3.
13. Alasbali T, Smith M, Geffen N, Trope GE, Flanagan JG, Jin Y, Buys YM. Discrepancy between results and abstract conclusions in industry- vs nonindustry-funded studies comparing topical prostaglandins. Am J Ophthalmol 2009;147:33-8.
14. http://sciencecareers.sciencemag.org/career_magazine/previous_issues/articles/2008_11_14/caredit.a0800165 .
15. Lewin JS. Industrial-academic research relationships: departmental collaborations. Radiology 2009;250(1):23-7.
16. https://services.aamc.org/Publications/index.cfm?fuseaction=Product.displayForm&prd_id=232&prv_id=281 .
17. Steinbrook, R. Online disclosure of physician-industry relationships. N Engl J Med 2009;360(4):325-7. 18. www.prescriptionproject.org/tools/solutions_factsheets/files/0008.pdf .

©2009 The Triological Society