Conflict of interest A conflict of interest (COI) is a situation in which a person or organization is involved in multiple interests, financial or otherwise, and serving one interest could involve working against another. Typically, this relates to situations i ...

in the

health care industry The healthcare industry (also called the medical industry or health economy) is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, a ...

occurs when the primary goal of protecting and increasing the

health Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...

patients A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health c ...

comes into conflict with any other secondary goal, especially personal gain to healthcare professionals, and increasing

revenue In accounting, revenue is the total amount of income generated by the sale of goods and services related to the primary operations of the business. Commercial revenue may also be referred to as sales or as turnover. Some companies receive reven ...

to a healthcare organization from selling

health care Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profe ...

products and services. The public and private sectors of the medical-industrial complex have various conflicts of interest which are specific to these entities.

Trends

There is a lack of

empirical evidence Empirical evidence for a proposition is evidence, i.e. what supports or counters this proposition, that is constituted by or accessible to sense experience or experimental procedure. Empirical evidence is of central importance to the sciences and ...

to describe the impact of conflict of interest in the health care industry. Business interests influence the direction of cancer research and the adoption of new practices in therapy. University projects which receive industry funding are more likely to produce research outcomes which favor their funders. A 2017

systematic review A systematic review is a Literature review, scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from publ ...

by the

Cochrane Collaboration Cochrane (previously known as the Cochrane Collaboration) is a British international charitable organisation formed to organise medical research findings to facilitate evidence-based choices about health interventions involving health profess ...

found that pharmaceutical and medical device industry sponsored studies are more often favorable to the sponsor's product compared with studies with other sources of sponsorship. The trend toward treating

clinical research Clinical research is a branch of healthcare science that determines the safety and effectiveness ( efficacy) of medications, devices, diagnostic products and treatment regimens intended for human use. These may be used for prevention, treatm ...

as a business has coincided with a range of problems which are likely the result of business connections. Funders seek and court scientists to author papers and lend their person reputations to add credibility to research findings. Physicians in general practice also face potential conflicts of interest. For example, the

Physician Payments Sunshine Act The Physician Payments Sunshine Act is a 2010 United States healthcare law to increase transparency of financial relationships between health care providers and pharmaceutical manufacturers. About The Sunshine Act requires manufacturers of drugs ...

of 2010 requires that financial relationships of physicians and teaching hospitals with manufacturers be reported and made publicly available via th
Open Payments Program website
Using this Open Payments database, it was found that about 64% of US-based physician-editors of highly cited

medical journal A medical journal is a peer-reviewed scientific journal that communicates medical information to physicians, other health professionals. Journals that cover many medical specialties are sometimes called general medical journals. History The first ...

s received industry-associated payments (i.e., payments from medical drug and device companies) during a period spanning August 1, 2013 to December 31, 2016. Medical journals have varying requirements what should be published and people who fail to follow them face few repercussions. The medical-industrial complex describes the conflict of interest present between physicians and the healthcare industry. Physicians who invest in medical device companies may be biased towards certain medical devices or treatments, creating a conflict of interest between doing what is best for a patient versus what is in their best financial interest. Conflict of interest in continuing medical education is also present, where physicians learn how to use certain medical devices during their board-certification courses that affect their patients.Relman, Arnold S. "Doctors as the Key to Health Care Reform." ''The New England journal of medicine.'' 361, no. 13 (2009): 1225–1227.

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References

Further reading