Intended for healthcare professionals

Views & Reviews Personal View

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

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

21 January 2014
P Grant
Physician
retired
Randwick 2031