Has the regulation of physician-industry relationships gone too far? Regulation is harmful.
Start with three facts: First, diseases kill people. Treatments, including medications, help to manage and cure diseases.
Second, physicians working with industry have developed and made available most current treatments. This working relationship includes research and development, physician education, and joint monitoring for postmarketing safety. There is tremendous value in this working relationship for science, the practice of medicine, and for patients.
And third, participation in research and development, and education of peers on this research, is part of the legal, moral, and ethical work product of physicians. Payment for the work we do is not a "conflict" of interest. Rather, it represents a commonality of interests which is an integral part of the profession of medicine (Endocr. Pract. 2009;15:289). There is improvement in patient care, advancement of science, and benefit to medicine from these professional activities.
Given these facts, one must question the wisdom of disrupting the physician-industry working relationship. Those who claim that physicians working with industry are immoral, unethical unethical
said of conduct not conforming with professional ethics. , or corrupt create harm to patients and to medicine. They will cost society not just the public's trust, but also the human costs of hindering hin·der 1
v. hin·dered, hin·der·ing, hin·ders
1. To be or get in the way of.
2. To obstruct or delay the progress of.
v.intr. research and development and disrupting the expedient ex·pe·di·ent
1. Appropriate to a purpose.
a. Serving to promote one's interest: was merciful only when mercy was expedient.
b. implementation of newer, safer, better treatments. Ultimately, untreated disease will incur higher costs.
Opponents of the physician-industry working relationship want better patient care. We all do. Let's agree that disclosure of working relationships is important--let's also agree not to call it a "conflict." Finally, let's agree that "gracious gra·cious
1. Characterized by kindness and warm courtesy.
2. Characterized by tact and propriety: responded to the insult with gracious humor.
3. professionalism," which fundamentally says you will behave as if your grandmother were watching, should be the standard for any debate.
Physicians should take the lead in all clinical research and in the development of education. Those who carry on the research should be the ones to pass on the knowledge to their peers. They are the most expert by both necessity and experience, and thus must not be excluded from CME-accredited programs, with proper disclosure. "Teaching" that there is bias in industry-funded education lacks balance.
We should be proud of the value that comes to science, the profession of medicine, and patient care from the constructive partnership between physicians and industry.
By J. MICHAEL GONEALEZ-CAMPOY, M.D., PH.D.
DR. GONZALEZ-CAMPOY is an endocrinologist endocrinologist /en·do·cri·nol·o·gist/ (en?do-kri-nol´ah-jist) a specialist in endocrinology.
Endocrinologist in Eagan, Minn., a charter member of the Association of Clinical Researchers and Educators, and a member of the American Association of Clinical Endocrinologists board of directors.