Controlling Conflict of Interest

The prestigious NEJM have published an article in the current on-line edition "Controlling Conflict of Interest - Proposals from the Institute of Medicine", By Sr. Robert Steinbrook.

The article starts by defining what is conflict of interest :"a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest." The primary interests of concern include "promoting and protecting the integrity of research, the welfare of patients, and the quality of medical education." Secondary interests "may include not only financial gain but also the desire for professional advancement, recognition for personal achievement and favors to friends and family or to students and colleagues."

The article covers the recommendations of the IOM and of particular interest to me is the following from the article: Academic medical centers, teaching hospitals, faculty members, students, residents, and fellows should "reform relationships with industry in medical education"; these institutions and professional societies "should provide education on conflict of interest."....

To read the entire article, please follow this link: http://content.nejm.org/cgi/content/full/NEJMp0810200?query=TOC

WHEN IS A CONSULTANCY A KICKBACK?

Department of Justice Picks Up the Knife

Today's NYT has an interesting article about the DOJ's current move toward increased civil and criminal prosecution against physicians--mostly surgeons--who ask for kickbacks from device companies for using their products.

But what is a kickback? And how does one distinguish between what companies and docs might call consultancy arrangements and the DOJ calls criminal behavior? Is it a question of proving purely self-aggrandizing intent--having, in essence, recordings of docs making sweet deals for themselves? And at what point does this become criminal behavior rather than a violation of professional ethics?

Curious minds really do want to know.

http://www.nytimes.com/2009/03/04/health/policy/04doctors.html?emc=tnt&tntemail0=y