Letters Who is paying your doctor?

Eradicate commercial interests from official medical education

BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g4976 (Published 05 August 2014) Cite this as: BMJ 2014;349:g4976
  1. Paolo Vercellini, associate professor of obstetrics and gynaecology1,
  2. Paola Viganò, in vitro fertilisation laboratory director2,
  3. Edgardo Somigliana, infertility unit director3
  1. 1Department of Obstetrics and Gynaecology, Università degli Studi and Fondazione Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
  2. 2Department of Obstetrics and Gynaecology, San Raffaele Scientific Institute, Milan, Italy
  3. 3Infertility Unit, Fondazione Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
  1. paolo.vercellini{at}unimi.it

Dyer describes international initiatives to promote public disclosure of payments from industry to doctors, thereby enabling patients to tell whether their treatment might be influenced by commercial interests.1 Coombes suggests that messages from key opinion leaders paid by drug companies to advise on marketing strategies, present at conferences, or write in medical journals may be biased.2

It is important to uncover these links between industry and individual doctors, but the problem is broader and other stakeholders play a role. These include academic institutions that obtain industry funding, medical journals that gain from advertising and selling of reprints, patient organisations that receive support from drug companies,3 and scientific societies that depend on industry for organising their meetings. In such a globally distorted system, patients may be unable to orientate themselves despite individual disclosures. Because connivance is so pervasive, disclosure should not remain a stand alone measure, otherwise its effect on bias mitigation would be uncertain.4

Our ultimate goal should be the eradication of commercial interests from official medical education.5 Scientific societies, editorial boards, and conference organising committees should be free of conflicting interests. Improvement in quality of information would more than compensate for a likely reduction in quantity. Medical schools should select tutors, lecturers, and professors with no competing interests. Classes on ethics and relations with industry should be an integral part of students’ training. Primary prevention through educating younger generations of doctors according to the highest ethical standards could be the best way to combat influence and bias.


Cite this as: BMJ 2014;349:g4976



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