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Kaplan: Conflicts Destroy Trust

On the Conflict of Interest Blog, Jeff Kaplan had a thoughtful post a few days ago. It’s a reminder how conflicts (like graft) can turn any of us into victims — without our ever knowing what happened.

He said,

Probably the two most prominent COI stories recently in the news concern insider trading by members of Congress and David Stern’s running both the NBA and one of its teams.

But the most instructive piece about COIs that I’ve seen in the past few days concerns a woman with MS learning from a state data base of pharma company payments to doctors that her physician had received more than $300,000 in such payments, with “the makers of the two drugs he had recommended to her listed as major contributors.”

She notes: “As a patient experiencing a neurological disease that has no known cause and no known cure, I expected my neurologist to be direct and honest with me. I expected honesty in interpreting my MRIs; in giving me a prognosis; in explaining his rationale behind treatment recommendations and in providing verifiable, scientific information about them; in educating me about MS; and in telling me about any conflicts of interest with drug companies. Actually, I expected that my neurologist would have no financial conflicts of interest whatsoever.”

The story powerfully illustrates the general point that COIs can be devastating to important  relationships of trust – and, as you can imagine, the woman found it impossible to continue receiving treatment from this doctor.

The story also shows that disclosure can be helpful, but note this conclusion. “At the end of [my conversation with my new doctor,] I asked if many patients inquire about possible conflicts of interest. He shook his head ‘no.’ I was the only one.”

Jeff Kaplan’s post is here.

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