Conflicts of Interest: Can a physician serve two masters?

Clinics in Dermatology

Volumn 30, Issue 2, 2012, Pages 160-173

  Greenberg, Robert D ^a  

^a Private Practice   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CONFLICT OF INTEREST; CONSCIENCE; CONTINUING EDUCATION; DOCTOR PATIENT RELATION; GOVERNMENT REGULATION; HISTORY OF MEDICINE; HUMAN; INTERPERSONAL COMMUNICATION; LAW SUIT; MEDICAL ETHICS; MEDICAL LITERATURE; MEDICAL PRACTICE; MEDICAL RESEARCH; MEDICAL SOCIETY; NOTE; PATIENT AUTONOMY; PHYSICIAN ATTITUDE; PRACTICE GUIDELINE; PRIORITY JOURNAL; PROFESSIONAL COMPETENCE; PROFESSIONAL STANDARD; RESPONSIBILITY;

CODES OF ETHICS; CONFLICT OF INTEREST; DERMATOLOGY; DISCLOSURE; DRUG INDUSTRY; EDUCATION, MEDICAL, CONTINUING; ETHICS, MEDICAL; ETHICS, RESEARCH; GOVERNMENT REGULATION; HUMANS; PERIODICALS AS TOPIC; PRACTICE GUIDELINES AS TOPIC; SOCIETIES, MEDICAL; UNITED STATES;

EID: 84856959400     PISSN: 0738081X     EISSN: 18791131     Source Type: Journal    
DOI: 10.1016/j.clindermatol.2011.06.003     Document Type: Note

References (69)

1. Lo B. Resolving ethical dilemmas: a guide for clinicians 2005, Lippincott Williams & Wilkins, Philadelphia.
2. Shaw G.B. The doctor's dilemma: preface on doctors. Kindle DX version. 2006 Retrieved from, [Original work published 1909]. http://Amazon.com.
3. Matthew 6:24 (New International Version).
4. IOM (Institute of Medicine) Conflict of interest in medical research, education, and practice 2009, The National Academies Press, Washington (DC).
5. May W.F. Money and the medical profession. Kennedy Inst Ethics J 1997, 7:1-13.
6. Wazana A. Physicians and the pharmaceutical industry: is a gift ever just a gift?. JAMA 2000, 283:373-380.
7. Katz D., Caplan A.L., Merz J.F. All gifts large and small. Toward an understanding of the ethics of pharmaceutical industry gift-giving. Am J Bioeth 2003, 3:39-46.
8. Blumenthal D. Doctors and drug companies. N Engl J Med 2004, 351:1885-1890.
9. Dana J., Loewenstein G. A social science perspective on gifts to physicians from industry. JAMA 2003, 290:252-255.
10. Cosgrove L., Bursztajn H.J., Krinsky S., Anaya M., Walker J. Conflicts of interest and disclosure in the American Psychiatric Association's Clinical Practice Guidelines. Psychother Psychosom 2009, 78:228-232.
11. Hippocratic Oath. Wikipedia Available at:, Accessed July 28, 2010. http://en.wikipedia.org/wiki/Hippocratic_Oath.
12. American Medical Association Principles of medical ethics Available at:, Accessed July 28, 2010. http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.page?
13. The Oath of Maimonides. Wikipedia Available at:, Accessed August 12, 2010. http://en.citizendium.org/wiki/Oath__of__Maimonides.
14. American Medical Student Association Model Oath for New Physicians Available at:, Accessed July 28, 2010. http://www.amsa.org/AMSA/Homepage/About/Priorities/Professional.aspx.
15. Members of the Medical Professionalism Project Medical professionalism in the new millennium: a physician charter. Ann Intern Med 2002, 136:243-246.
16. Lesser C.S., Fineberg H.V., Cassel C.K. Physician payment reform: principles that should shape it. Health Aff (Milwood) 2010, 29:948-952.
17. Medicare Payment Advisory Commission Report to Congress: Aligning Incentives in Medicare 2010, MedPAC, Washington (DC).
18. Iglehart J.K. The ACA's new weapons against health care fraud. N Engl J Med 2010, 363:304-306.
19. Relman A.S. Separating continuing medical education from pharmaceutical marketing. JAMA 2001, 285:2009-2012.
20. Porter R. The greatest benefit to mankind: a medical history of humanity 1997, W.W. Norton, New York (NY).
21. Petrock V., Elkin T. Marketing to Healthcare Professionals Online. eMarketer 2010, Available at:, Accessed November 8, 2010. http://www.emarketer.com/Results.aspx?dsNav=Ntk:basic%7cmarketing+to+healthcare+professionals+online%7c1%7c.
22. Gagnon M.A., Lexchin J. The cost of pushing pills: a new estimate of pharmaceutical promotion expenditures in the United States. PLoS Med 2008, 5:e1.
23. Kendall B, Brin DW. Novartis unit to pay $422.5 million in marketing case. Wall Street J Section B, Page 5. October 10, 2010.
24. Fuhrmans V. Doctors paid to prescribe generic pills. Wall Street J Section B, Page 1 January 24, 2008.
25. Choudhry N.K., Stelfox H.T., Detsky A.S. Relationships between authors of clinical practice guidelines and the pharmaceutical industry. JAMA 2002, 287:612-617.
26. Campbell E.G., Rao S.R., DesRoches C.M., et al. Physician professionalism and changes in physician-industry relationships from 2004 to 2009. Arch Intern Med 2010, 170:1820-1826.
27. Kaiser Family Foundation National Survey of Physicians part II: Doctors and Prescription Drugs 2002, KFF, Menlo Park (Calif), Available at:, Accessed August 10, 2010. http://kff.org/rxdrugs/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=13965.
28. HHS Office of Inspector General OIG Compliance Program Guidance for Pharmaceutical Manufacturers. Fed Regist 2003, 68:23731-23743.
29. Pharmaceutical Research and Manufacturers of America PhRMA code on interactions with healthcare professionals 2002, PhRMA, Washington (DC), Available at:, Accessed August 10, 2010. http://www.phrma.org/sites/default/files/108/phrma_marketing_code_2008.pdf.
30. Advanced Medical Technology Association Code of Ethics on Interactions with Health Care Professionals 2009, Effective July 1, AdvaMed, Washington (DC), Available at:, Accessed August 11, 2010. http://advamed.org/NR/rdonlyres/61D30455-F7E9-4081-B219-12D6CE347585/0/AdvaMedCodeofEthicsRevisedandREstatedEffective20090701.pdf.
31. Tufts A. Only 6% of drug advertising material is supported by evidence. BMJ 2004, 328:485.
32. Ziegler M.G., Lew P., Singer B.C. The accuracy of drug information from pharmaceutical sales representatives. JAMA 1995, 273:1296-1298.
33. Brook R.H. Physician compensation, cost, and quality. JAMA 2010, 304:795-796.
34. Latham S.R. Conflict of interest in medical practice. Conflict of interest in the professions 2001, 279-301. Oxford University Press, Oxford. M. Davis, A. Stark (Eds.).
35. Castanedo M.P., Baumann L. Ethics of selling health care. Clin Dermatol 2009, 27:355-358.
36. Gormley D.E. There is nothing wrong with dermatologists selling products to patients!. Arch Dermatol 1999, 135:765-766.
37. Miller R.C. Dermatologists should guard their patients' purse, not pick their pockets!. Arch Dermatol 1999, 135:255-256.
38. American Academy of Dermatology/Association Position Statement of Dispensing. 1999 Available at:, Accessed October 30, 2010. http://www.aad.org/Forms/Policies/Uploads/PS/PS-Dispensing.pdf.
39. Lombardo P.C. The American Academy of Dermatology should not endorse product sales from physicians' offices. Arch Dermatol 1999, 135:995.
40. Morris L., Taitsman J.K. The agenda for continuing medical education-limiting industry's influence. N Engl J Med 2009, 361:2478-2481.
41. Relman A.S. Industry support of medical education. JAMA 2008, 300:1071-1073.
42. ACCME annual report 2008, Accreditation Council for Continuing Medical Education, Chicago.
43. American Medical Association Council on Ethical and Judicial Affairs ndustry support of professional education in medicine. 2008 Available at:, Accessed October 28, 2010. http://www.ama-assn.org/ama1/pub/upload/mm/471/ceja1-2.doc.
44. Association of American Medical Colleges Industry funding of medical education: report of an AAMC task force. 2008 Available at:, Accessed October 28, 2010. http://www.aamc.org/industryfunding.
45. Accreditation Council for Continuing Medical Education Standards for Commercial Support. Updated 2007 Available at:, Accessed October 28, 2010. http://www.accme.org.
46. Holmer A.F. Industry strongly supports continuing medical education. JAMA 2001, 285:2012-2014.
47. Sniderman A.D., Furberg C.D. Why guideline-making requires reform. JAMA 2009, 301:429-431.
48. Steinbrook R. Guidance for guidelines. N Engl J Med 2007, 356:331-333.
49. Agency for Healthcare Research and Quality National Guideline Clearinghouse Updated October 25, 2010. Available at:, Accessed October 28, 2010. http://www.guideline.gov/index.aspx.
50. Davidoff F., DeAngelis C.D., Drazen J.M., et al. Sponsorship, authorship, and accountability. N Engl J Med 2001, 345:825-827.
51. DeAngelis C.D., Fontanarosa P.B. Impugning the Integrity of medical science: the adverse effects of industry influence. JAMA 2008, 299:1833-1835.
52. Blum J.A., Freeman K., Dart R.C., Cooper R.J. Requirements and definitions in conflict of interest policies of medical journals. JAMA 2009, 302:2230-2234.
53. Drazen J., de Leeuw P.W., Laine C., et al. Toward more uniform conflict disclosures-the updated ICMJE conflict of interest reporting form. N Engl J Med 2010, 363:188-189.
54. Angell M. Industry-sponsored clinical research. A broken system. JAMA 2008, 300:1069-1071.
55. Wilson D. A tougher conflict policy at Harvard Medical School. NY Times Section B, Page 4. July 22, 2010.
56. US Department of Health & Human Services, National Institutes of Health NIH Budget Available at:, Accessed October 30, 2010. http://nih.gov/about/budget.htm.
57. Rockey S.J., Collins F.S. Managing financial conflict of interest in biomedical research. JAMA 2010, 303:2400-2402.
58. Campbell E.G., Zinner D.E. Disclosing industry relationships-toward an improved federal research policy. N Eng J Med 2010, 363:604-606.
59. Weinfurt K.P., Hall M.A., King N.M.P., et al. Disclosure of financial relationships to participants in clinical research. N Eng J Med 2009, 361:916-921.
60. Anderson M., Kragstrup J., Sondergaard J. How conducting a clinical trial affects physicians' guideline adherence and drug preferences. JAMA 2006, 295:2759-2764.
61. Perlis C.S., Harwood M., Perlis R.H. Extent and impact of industry sponsored conflicts of interest in dermatology research. J Am Acad Dermatol 2005, 52:967-971.
62. Rothman D.J., McDonald W.J., Berkowitz C.D., et al. Professional medical associations and their relationships with industry. A proposal for controlling conflict of interest. JAMA 2009, 301:1367-1372.
63. Relman A.S. Medical professionalism in a commercialized health care market. JAMA 2007, 298:2668-2670.
64. Steinbrook R. Disclosure of industry payments to physicians. N Eng J Med 2008, 359:559-561.
65. Council of Medical Specialty Societies Code for Interactions with Companies Published April 21, 2010. Available at:, Accessed October 30, 2010. http://www.cmss.org/uploadedFiles/Site/CMSS_Policies/CMSS%20Code%20for%20Interactions%20with%20Companies%204-19-10.pdf.
66. American Academy of Dermatology Administrative Regulations. Code for Interactions with Companies Available at:, Accessed October 30, 2010. http://www.aad.org/Forms/Policies/Uploads/AR/AR%20Code%20for%20Interactions%20with%20Companies.pdf.
67. Steinbrook R. Online disclosure of physician-industry relationships. N Eng J Med 2009, 360:325-327.
68. Okike K., Kocher M.S., Wei E.X., Mehlman C.T., Bhandari M. Accuracy of conflict-of-interest disclosures reported by physicians. N Engl J Med 2009, 361:1466-1474.
69. Jain S.H., Cassel C.K. Societal perceptions of physicians: knights, knaves, or pawns?. JAMA 2010, 304:1009-1010.