Doctors' Conflict-of-Interest; What it Looks Like and What to do About it

Conflict-of-interest (COI) between doctors and the pharmaceutical industry is widespread and is present in the majority of practitioners. The effects of COI on how doctors prescribe and hence on the health of their patients is negative. This article first summarizes the widespread nature of COI and then examines what forms it takes and how doctors view COI. It next looks at the two ways that have been used to try and limit its influence - managing COI and avoiding COI - and shows that managing COI by limiting gifts to small amounts and relying on declaring COI are based on false assumptions and have little chance of producing any positive results. It then goes on to review the measures that have been shown to be beneficial, particularly policies and legislation restricting or prohibiting certain types of COI among medical students, residents and practicing doctors. Finally, this article looks at how to build upon the successes that have occurred and what more could be done.