Forum Session

Conflicts of Interest in Medicine: What's the Problem?
May 15, 2009


Michele J. Orza, ScD


Over the past few years the drumbeat of concern about conflicts of interest in all aspects of medicine—from medical education to research to practice—has been growing louder. Recently, its rhythm has intensified, and now hardly a week goes by without a newspaper article about a particularly egregious example of conflicting interests or an announcement of some new institutional policy or recommendations to improve the situation. In the past few months alone, there have been an uprising among medical students; policy announcements from dozens of industry groups, medical institutions, and professional associations; and recommendations from the Medicare Payment Advisory Commission and an Institute of Medicine committee.

This session was the first of two intended to examine the vast and complex landscape of conflicts of interest in medicine, and it focused on the evidence base underlying the concerns that have received increased attention of late. The speakers for this session, highly knowledgeable about the evidence base for the extent and impact of conflicts of interest, offered differing opinions about the interpretation of this evidence and its policy implications.


Eric Campbell, PhD, Associate Professor, Institute for Health Policy, Massachusetts General Hospital and Harvard Medical School; Lisa Bero, PhD, Professor and Vice Chair, Department of Clinical Pharmacy, Professor, Institute for Health Policy Studies, and Co-Director, San Francisco Cochrane Center, University of California, San Francisco; Ronald Bailey, Science Correspondent, Reason Magazine and Adjunct Scholar, Cato Institute and Competitive Enterprise Institute.

Slides for the presentations by Dr. Campbell, Dr. Bero, and Mr. Bailey are available for download. Speakers' biographies are also available.

Related Materials

See also the follow-on session, "Conflicts of Interest in Medicine II: Issues Surrounding Industry Funding of Physician Education" (Forum Session, December 11, 2009).

For closely related work on this topic, see entries for the following Forum sessions: "The Ethics in Patient Referrals Act: The Stark Law and the Practice of Medicine" (December 14, 2007), "Medical Imaging Services: Utilization, Spending, and Appropriateness" (November 13, 2008), "Exploring Comparative Effectiveness: Fundamentals of Evidence-Based Health and Introduction to the Cochrane Collaboration" (July 25, 2008), and "Exploring Comparative Effectiveness: Options for Expanding U.S. Capacity" (December 17, 2008).

For a comprehensive overview, see the work of the Institute of Medicine's Committee on Conflict of Interest in Medical Research, Education, and Practice.

See also "Scrutinizing Industry-Funded Science: The Crusade Against Conflicts of Interest" (Ronald Bailey, American Council on Science and Health, April 2, 2008).

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