Regulating Conflicts of Interest in Health Care: Shades of Difference

This is tooting my own horn, but please see my article on conflict of interest in the Spring 2006 edition of the Rhode Island chapter of the American College of Physicians Governor's Newsletter (starts on page 5). My main points reflected my previous response to the article in JAMA by Brenan et al (Brennan TA et al. Health industry practices that create conflicts of interest: a policy proposal for academic medical centers. JAMA 2006; 295: 429-433.). They were:

Conflicts of interest are a very important challenge to physicians’ professionalism and to the integrity of health care in general.
Brennan et al implied that the only important conflicts of interest involve physicians’ relationships to drug and device companies. However, serious conflicts of interest may affect physicians’ interactions with other organizations, and affect health care decision makers other than physicians.
Brennan et al suggested putting AMC leaders in charge of enforcing conflict of interest rules on physicians, without imposing any particular rules about conflicts of interest on these leaders. This implication is that AMC leaders are more ethical
and less susceptible to conflicts of interests than are physicians. The evidence, however, suggests otherwise.
Thus, I suggest another approach: a broad set of principles about conflicts of interest, and more generally about business ethics in health care. These principles should apply to all who make decisions in health care: physicians, other health
care professionals, and health care bureaucrats, managers, and executives. The details of the implementation of these principles could vary, depending on the context and setting.
Furthermore, conflicts of interest and the ethics of health care are too important to be left to bureaucrats, managers, and executives. Physicians must find the time and make the effort to defend our professional values, remembering first that, “A physician shall, while caring for a patient, regard responsibility to the patient as paramount.”

Couldn't have said it better myself... ;-)

Of course, I strongly advocate reading the whole thing.