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How to eliminate ‘any possible conflicts of interest’.

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There is a story posted at ProPublica (and co-published with the Chicago Tribune) that examines a particular psychiatrist who was paid by a pharmaceutical company to travel around the U.S. to promote one of that company’s antipsychotic drugs. Meanwhile, the psychiatrist was writing thousands of prescriptions for that same antipsychotic drug for his patients on Medicaid.

You might think that there would be at least the appearance of a conflict of interest here. However, the psychiatrist in question seems certain that there is not:

In an interview and in response to written questions, [Chicago psychiatrist Dr. Michael] Reinstein said industry payments he has received for speeches and other engagements have had no bearing on his research results or patient care. He said he does not “accept any money from corporations to study their medications. This eliminates any possible conflicts of interest.”

(Bold emphasis added.)

So, dear readers, does Dr. Reinstein’s plan for eliminating conflicts of interest (COIs) strike you as plausible?

If not, are there further steps you think someone in a similar career situation ought to be taking to disclose and manage such potential COIs?

Do you think this might be the kind of COI that cannot plausibly be managed? (If so, what features do you think distinguish manageable COIs from impossible ones?)

Finally, are we to the point where we need a serious body of social scientific research that follows psychiatrists (among other scientists who draw their financial support from private and public sources) to get some hard data on what kind of influence various financial arrangements actually exert on their prescribing behavior and research results?


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