Conflicts of Interest in Drug Prescribing

As reimbursements continue to decrease every year, physicians must be extremely financial savvy in order to survive. Some areas of the United States can’t seem to find enough doctors (think middle of the country), whereas others have a glut of doctors (think West and East Coasts). Coupled with the tough financial climate, there is the competition among practitioners who need to make a living in medicine to pay their bills and support their family. The golden days of doctors being rich off of their profession simply do not exist anymore. In order to do that, physicians must invest their income and make wise financial decisions.

There is often a conflict that arises when physicians invest their money. Most of this is because people tend to invest in what they know best. If I am an endocrinologist, I know my field the best and am likely to invest in those promising companies that produce drugs that can drastically improve the health of my patients. Investing in what you know about is a basic necessity for success.

What happens when financial interest loom in the background among medical decisions? We as physicians have many choices in prescribing. Many drugs do the same thing but some are much much more expensive than others. Do we inadvertently allow ourselves to be influenced by our financial interests or the influences of generous drug representatives who bring us lunch or buy us dinner?

It’s a difficult thing because capitalism runs the economy and medicine is a business. Right now the rules are only coming around to suggest that physicians with financial interests should disclose those to patients and to the hospitals at which they work. Is the time coming where physicians won’t be able to have any financial interests in their own field?

As a doctor myself, I know that I am involved in medicine to help people. That brings me joy and that makes me tick. However, I need to make a living. My Hippocratic Oath says that I will do whatever I can to help, but it does not necessarily address financial conflicts of interest. My treatment regimens have nothing to do with my financial interests. I hope all other physicians can say the same thing.