Understanding financial conflicts of interest.

@article{Thompson1993UnderstandingFC,
  title={Understanding financial conflicts of interest.},
  author={D. F. Thompson},
  journal={The New England journal of medicine},
  year={1993},
  volume={329 8},
  pages={
          573-6
        }
}
  • D. Thompson
  • Published 19 August 1993
  • Medicine, Political Science
  • The New England journal of medicine
The problem of conflicts of interest began to receive serious attention in the medical literature in the 1980s1,2. Studies have described a wide range of conflicts involving physicians, medical researchers, and medical institutions (the most comprehensive is by Rodwin3). Among the areas of concern are self-referral by physicians,4–6 physicians' risk sharing in health maintenance organizations (HMOs) and hospitals,7 gifts from drug companies to physicians,8,9 hospital purchasing and bonding… 
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References

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The Council on Ethical and Judicial Affairs revisits the question of referral of patients to medical facilities in which physicians have financial interests and concludes that, in general, physicians should not refer patients to a health care facility outside their office practice when they have an investment interest in the facility.

Physicians, entrepreneurism and the problem of conflict of interest

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Physicians' Conflicts of Interest: The Limitations of Disclosure

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Examination of disclosure policies in four other contexts - medical informed consent, consumer-protection laws, disclosure by lawyers to clients, and disclosure by government officials - and their implications and limitations as models for disclosing physicians' conflicts of interest are examined.

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Disclosure policies are supposed to reduce problems of scientific misconduct ranging from sloppiness to fraud by allowing readers to make a more informed and therefore a better interpretation of published work.

Conflict of interest and the BMJ

Conflict of interest may also arise with letters, and many letters that seem to come from individuals who simply have an interest in the subject are in fact prompted by organisations with an interest, financial or otherwise, in the outcome of the correspondence.

How do financial incentives affect physicians' clinical decisions and the financial performance of health maintenance organizations?

The use of some, but not all, financial incentives, as well as the type of HMO, does influence the behavior of physicians toward patients, and it remains to be determined how these factors affect the quality of care.

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Closer attention from the public and the profession, and careful study, are necessary to ensure that the "medical-industrial complex" puts the interests of the pub...

Must the law assure ethical behavior?

It is not surprising that physicians would look for ways to enhance the availability of all this burgeoning technology by reducing the volume of care given by reducing individual reimbursement: a shaky hypothesis at best.

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An effective legal or ethical response to self referral arrangements must acknowledge and balance both the possible pro-competitive effects of such arrangements and the inherent potential for abuses in this type of business practice.