Correspondence
Conflicts of Interest
N Engl J Med 1994; 330:503February 17, 1994
- Article
To the Editor:
Despite the best of intentions, seemingly impartial members of an academic medical section frequently have a vested interest in the ongoing use and widespread medical acceptance of technical procedures and intellectual paradigms emanating from that department. The use of such procedures and the acceptance of such paradigms may bring not only financial remuneration to the individual members and the department but also academic prestige and advancement; more space, technical personnel, and trainees; increased grant support; and overall departmental growth. Conformity to departmental paradigms and reliance on departmental technical procedures are further enhanced by both the collegial nature and the hierarchical structure of these departments. This pervasive array of secondary influences has the potential, as Thompson puts it (Aug. 19 issue),1 to “dominate the relevant primary interest in the making of professional decisions” in a manner little different from that which exists in commercial ventures.
1 ReferencesArnold L. Lentnek, M.D.
77 E. Andrews Dr., N.W., Suite 146, Atlanta, GA 303051
Thompson DF . Understanding financial conflicts of interest. N Engl J Med 1993;329:573-576
Full Text | Web of Science | Medline
To the Editor:
Conflict of interest can be defined as a situation in which professional judgment concerning a primary interest (e.g., a patient's health) can be influenced by a secondary interest (e.g., the provider's financial gain). Taking away from physicians the opportunity to benefit financially from their patient-care decisions might be an excellent idea. But simply transferring that opportunity to some other entity (such as a health maintenance organization or an insurance company) -- which still has a conflict between its own reward and the patient's benefit -- does not seem to eliminate the problem.
Wolffe Nadoolman, M.B.A.
Yale University School of Medicine, New Haven, CT 06504
