Understanding Financial Conflicts of Interest

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Abstract
The problem of conflicts of interest began to receive serious attention in the medical literature in the 1980s1,2. Studies have described a wide range of conflicts involving physicians, medical researchers, and medical institutions (the most comprehensive is by Rodwin3). Among the areas of concern are self-referral by physicians,46 physicians' risk sharing in health maintenance organizations (HMOs) and hospitals,7 gifts from drug companies to physicians,8,9 hospital purchasing and bonding practices,3 industry-sponsored research,10,11 and research on patients12. Yet the concept of conflict of interest itself has been inadequately analyzed, and consequently its elements, the purposes . . .