Re: Patients can’t trust doctors’ advice if we hide our financial connections with drug companies
The issue in Dr Wen's article is of a primary interest (good patient care) being influenced by a secondary interest (personal gain for the practitioner). This is essentially the USA Institute of Medicine definition from its book 'Conflict of Interest' 2009.
But it's not only financial, or even free pizza, connections with drug companies that can threaten good practice.
I would suggest that if the drug company has any part in an 'educational event', even if there's no pizza, then practitioners can be influenced in a way favourable to the drug company (and contrary to a patient's interest), by way of: disease promotion; biased selection of therapeutic options; minimisation of treatment hazards; disregard for cost-effectiveness considerations.
The IOM definition of COI is about being influenced by a secondary interest. But even if there's no secondary interest practitioners can be influenced. The discussion needs to go well beyond conflicts of interest, to methods of influencing.
Competing interests: No competing interests