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Patients can’t trust doctors’ advice if we hide our financial connections with drug companies

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g167 (Published 15 January 2014) Cite this as: BMJ 2014;348:g167

Re: Patients can’t trust doctors’ advice if we hide our financial connections with drug companies

Dear Editors

I am writing the following declaration for the convenience of many doctors who have written in on this issue and may very well need to declare their financial conflict of interests.

To whom it concern:

I am currently renumerated on a regular basis by a health care organisation which is partially controlled by a select group of elected members and administered by non-elected group of people, in which I am obliged to administer treatment according to policies and guidelines set out by the organisation. If I detract from any official protocol, I will need to be prepared to show cause when asked.

My work is subject to review by people who are not necessarily versed in the nature of my field.

Furthermore I am entitled to additional monetary incentives or bonuses if I achieve certain performance target and goals set up by the organisation, regardless of evidence (or lack of) that achieving these target makes any difference in patient outcome. The system behind the awarding of these payment discourages taking on patient with complex conditions; key performance indicators are more likely to be attained if all the patients are managed according to the organisation's policies, regardless of individual case complexities.

I am subject to individual sanctions if my observed performance is not achieved, some targets being applied universally without accounting for regional variation or relevance to my field of practice.

Although I personally guarantee that my practice and management of my patients will not be dictated by these financial incentives or penalities, I cannot provide any better reassurance than medical practioners renumerated by other healthcare-related organisations.

And for the record, I am renumerated by the organisation called the National Health Service (England/Scotland/Wales)/ Health and Social Care in Northern Ireland (HSCNI) [please choose one]

Thank you

Signed on [insert date of declaration]

Dr [Your Name]
[Your appointment/position]
[Your NHS Trust Name]

For more information please visit

http://www.nottingham.ac.uk/business/documents/news-documents/evaluation...

http://www.monitor-nhsft.gov.uk/sites/default/files/publications/How%20c...

Competing interests: I am not renumerated by a UK health organisation which offer financial bonuses for performance-based target which is not necessarily evidence-based.

20 January 2014
Shyan Goh
Orthopaedic Surgeon
.
Sydney, Australia