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

BMJ 2014; 348 doi: (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

Besides totally agreeing with the opinion of Dr Wen, for me, the most interesting part in her story was the potential impact of conflict disclosure on real physician-physician relationships.

Obviously, most of our colleagues know the truth: patient never know the physicians, in front of them at every visiting, take kinds of hidden interests, which may therefore change the treatment, increase the cost and even be harmful to the patient’s health. This phenomenon still exists, even recently some steps of legislation, namely the “Sunshine Act”, were proposed to tighten the conflict of interest (COI) between physicians and pharmaceutical industry or medical instrument corporations. However, from the Legislation, it is not obligated that doctors should openly announce their COI to their patients.

Apparently, as the most important component in the COI controlling chains of “health Justice administration-physician-patient”, the last step was deliberately neglected.

Now suddenly, one hero bravely stepped out and prodded the hornet's nest, we can then image the complicated feeling of her partners, whose honey cheese was taken away because of her disclosure. And as reasonable, from her description, the most severe and malicious reactions were just from her colleagues. It is a true portrayal for current relationships between physicians after even a tiny "self-salvation". I was thankful to Dr Wen, whose paper accurately reminds us that the biggest barriers in COI limitation are not others, just practitioners themselves.

I can understand the pressure Dr Wen takes, as a break-rule pioneer. Her aggressive acts defend the purity of medicine and patient’s rights, however, simultaneously jeopardize the relationship with COI holding colleagues. Interestingly, there seems no alternative to avoid the above situation, except adding corresponding items in laws forcing COI open address to patients. From long run, it is definitely worth proposing and encouraging all physicians away from any financial connections with drug makers.

Competing interests: No competing interests

23 January 2014
Wei Huang
1st hospital of Dalian Medical university
222 Zhongshan Road, Department of Critical care medicine