Our Holiday Appeal: Speaking Out on Conflicts of Interest, Corruption, and Attacks on Science Since 2003

In 1998, I learned of the plight of Dr David Kern, my colleague and friend at Brown.  Dr Kern ultimately lost his job because a local company took offense when he presented data about a new occupational disease that occurred at the company's factory (see summary here).  Thus I was alerted to the growing dysfunction of US health care. 

To better understand health care dysfunction, I interviewed doctors and health professionals, and published the results in Poses RM.   A cautionary tale: the dysfunction of American health care.  Eur J Int Med 2003; 14(2): 123-130. (link here).  In that article, I postulated that US physicians were demoralized because their core values were under threat, and identified 5 concerns: 1. domination of large organizations which do not honor these core values 2. conflicts between competing interests and demands 3.  perverse incentives 4. ill-informed, incompetent, self-interested, or even corrupt leadership 5.  attacks on the scientific basis of medicine


Since then, my colleagues, some of who were original interviewees, and I have tried to raise awareness of these and related issues, now mainly through the Health Care Renewal blog.   For a long time, many of these issues remained relatively anechoic, partly because discussion of them offended those with vested interests in keeping the system the way it was.  After the economic crash of 2008, we began to realize that related issues were causing wider dysfunction, in the political economy, in the US and globally.

Who would have thought, though, that such issues would be in headlines every day, mainly pertaining to a presidential campaign, and now the presumptive incoming US administration?  Conflicts of interest, corruption, attacks on science, and even attacks on just plain facts are the stories of the day.  But you heard it here first on Health Care Renewal.

Maybe this will lead to some progress now on health care dysfunction, if the world does not blow up.

On that happy note, in this holiday season, I once again ask for contributions to FIRM - the Foundation for Integrity and Responsibility in Medicine.  We set up FIRM,  a US non-profit organization, to try to provide some financial support for HCR.   Despite the grandiose name, FIRM does not have an endowment, and is almost exclusively dependent on individual contributions.  (In the US, charitable foundations interested in health care or ethics seem to also regard health care corruption as a taboo topic, and have not been exactly forthcoming.)  So please consider contributing to FIRM.  FIRM is a US 501(c)3 non-profit organization, and so if you are in the US, contributions may be tax deductible according to US law.  Please send contributions to FIRM at 16 Cutler St, Suite 104, Warren, RI, 02885, and any questions or comments to me by email, rposes at firmfound dot org.