Oscar Wilde’s description of his emotional insecure protagonist Dorian Gray properly might speak to the dichotomous nature of clinicians and healthcare providers with pharmaceutical companies and medical device makers. “Excusing himself for this taint” refers to Gray’s embarrassment for managing coal mines, and yet Wilde points out that “the one advantage of having coal was that it enabled a gentleman to afford the decency of burning wood on his own hearth.”
Over the past few years, there has been intense scrutiny of potential conflicts of interests between physicians and industry, particularly stemming from the office Sen. Charles Grassley, R-Iowa. In fact, these inquiries have now extended to recipients who receive government grants, as just last week, the National Institutes of Health released new proposals to prevent financial conflicts of interest among researchers who receive federal funding.
Many of these inquiries have been well founded, especially in the case of Avandia, and the push toward transparency doesn’t seem to garner a lot open objectors.
This week, Medtronic joined the few companies that are now disclosing their financial relationships with physicians on a quarterly basis, revealing all physicians’ names and affiliations that received $5,000 or more in the first quarter of 2010.
Yet, some have suggested that the intense scrutiny could scare certain physicians away from forming relationships with companies that could later lead to better clinical care. Most recently, during a discussion on healthcare reform, former S.D. Senator Tom Daschle, and Dr. Richard I. Fogel, CEO of the Care Group, both expressed concerned that these probes may have gone too far, and therefore, could discourage beneficial relationships.
For instance, the FAME trial, whose two-year data was released this week, provides a prime example of how industry funding can inform clinical decisions for improved patient care—with potential cost savings.
While the potential conflicts of interests will continue to be probed and transparency is likely to proliferate, hopefully, this zeitgeist will not quell scientific and medical curiosity, as Wilde describes: “ There was no doubt that curiosity had much to do with it, curiosity and the desire for new experiences; yet it was not a simple but rather a very complex passion.”
On these topics, or any others, please feel free to contact me.