Conflicts of interest occur in health care when clinicians or researchers have personal, professional, or financial interests that could interfere with, or be perceived to interfere with, their professional obligation to act in the best interests of patients or objectively conduct, present, review, or publish research. Although the existence of a conflict does not necessarily mean wrong doing or harm, it does require management to prevent potential bias, or the perception of bias, in medical decision making or research.

Recent attention has focused on conflicts of interest between healthcare professionals and the drug industry. Marketing expenditures for drugs in 2004 was estimated at $57.5bn, nearly twice that spent on research and development.1 Drug and medical device companies have been convicted of criminal violations or have settled civil suits for offering clinicians millions of dollars in kickbacks, bribes, or gifts to get them to use their products. The most notable case illustrating how direct marketing to doctors …