The most recent issue of the Journal of the American Medical Association (JAMA) contains several articles on conflicts of interest, which we will share here throughout the week.
This Viewpoint piece — titled “Conflict of Interest: Why Does It Matter?” — is penned by former Institute of Medicine president Harvey V. Fineberg, MD, PhD.
* “Preservation of trust is the essential purpose of policies about conflict of interest. Therefore, the confidence of others in physician judgment is of paramount importance. When trust in physician judgment is impaired, the role of physicians is diminished.”
* “Many people tend to underestimate the influence of even relatively small financial relationships, and the fact of a relationship can be as salient as the amount of money involved. The power of feelings of reciprocation is the reason you receive preprinted return address labels with charitable solicitations. Included in about one-third of pieces of nonprofit direct mail, these small gifts substantially improve donation response rates.1 Even a stamped return envelope (compared with a business reply envelope) will prompt significantly more physicians to respond to a professional survey.”
* “In practical terms, policy about conflict of interest should be specific to the role, and clear about the financial thresholds and time frames that count, explicit about interests of individuals related to the person in question, and describe specific remedies, such as disclosure or exclusion. The policies should be public, readily understood, and applied evenhandedly.”
* “It is incumbent on the health professions to champion their reliance on evidence and disinterested expertise. Adherence to carefully considered, transparent, and evenhanded policies on conflict of interest can help physicians earn and maintain their trusted place in the minds of the public and policy makers.”