Are “Conflicts of Interest” Harmful or Helpful?

“Transparency” is a hot word in healthcare today, and while conflicts of interest should be disclosed, it would be harmful to eliminate the conflicts themselves. People do need to know if a speaker is invested in a company they are speaking about. Nothing, however, is inherently wrong with a conflict of interest if it is openly acknowledged. This applies to anything—but it especially holds true regarding the relationships between physicians and pharmaceutical companies.

A perceived conflict of interest in the pharmaceutical industry can actually be the basis for a relationship that can move healthcare forward and improve patient outcomes. Five reasons for this are:

1. The pharmaceutical companies are doing much of the research. While they are developing and testing new therapies, it is imperative that physicians are involved in the process. They are the ones that know what is needed from a medication, as well as what harms may be expected.

2. New medications are coming to market increasingly—and frequently. Without the pharmaceutical companies disseminating this information to physicians, we probably would not otherwise know about these novel new agents.

3. People object to the idea of doctors being paid to speak at events on behalf of pharmaceutical companies. However, these lectures are very informative and they allow physicians a view into what medical leaders are thinking. If not doctors, then who should be give these talks? I think the most skilled experts are the most capable—and they should not be engaged as speakers without compensation. Since no other industry expects their leaders to donate their time and ideas, doctors should be treated likewise. As long as any relationship is disclosed, there should be no issue.

4. Pharmaceutical companies need feedback from physicians, particularly in terms of how their products are working. We’ve all witnessed medications that come into the marketplace—and are then subsequently withdrawn. Understanding the needs, risks, benefits and effectiveness of medications is something better accomplished through the relationship between physicians and pharmaceutical companies. If we sever these ties, communication breaks down and real harm to patients can result.

5. Patients are living longer with more complex diseases. So even with a plethora of available medications, there are still not enough. As physicians, we need more weapons in our armamentarium to fight these increasingly complex diseases. Pharmaceutical companies don’t know what is needed without the input of doctors. Likewise, physicians do not know what can be developed without the experience and knowledge of pharmaceutical companies. In short, stamping out disease must become a team effort.

While many cry out against the “conflicts of interest” in medicine, it simply is impossible to eliminate them. If we want to keep pace with the rapidly changing complexity of diseases, we need to work together to come up with the treatments. Of course, this does not override transparency concerns. Make everything transparent, yes, but don’t destroy this bond. It is very much needed in our battle to cure patients. It is very much needed in medicine. If we were to eliminate these conflicts, how could we possibly develop and implement new medications?

  • Linda Girgis, MD, FAAFP

    Linda Girgis, MD, FAAFP, is Owner of Girgis Family Medicine LLC. Currently affiliated with St. Peter’s University Hospital and Raritan Bay Hospital, Linda also writes for Sermo, Physician’s Weekly, the Library of Medicine, and others.

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