Disclosing conflicts of interest to patients

Here is another article from JAMA’s theme issue on COI.

Negative cost incentives as COIs have received relative little attention in the past but are dealt with in this piece:

Physicians and hospitals can also participate in financial agreements in which they generate more revenue if less health care or less expensive medications or devices are used…

..considerable evidence suggests that these financial relationships may exert unconscious influences on physician behavior, particularly when the cost of care, rather than patient clinical outcomes, is involved.

That is a real concern and should present a huge problem to those among our leadership who advocate for the “new professionalism” under which the doctor is to simultaneously advocate for the patient and the population. That puts the individual clinician right in the middle of the conflict which, when disclosed (and disclose we must in this age of transparency) has the potential to undermine trust.