Volume 71 Number 4 September 2004	back to contents

Department of Internal Medicine, Carolina Medical Center, Davidson, NC.

Address all correspondence to Lance K. Stell, Ph.D., 102 North Main Street, Davidson, NC 28036.

Adapted from a presentation at the Issues in Medical Ethics 2001 Conference on “Medicine, Money and Morals” at the Mount Sinai School of Medicine, New York, NY on October 23, 2002, and updated February 2004.

ABSTRACT
This paper will attempt to demonstrate that conflict of interest is an unavoidable feature of medical practice, medical institutions, medical publications, and medical research. It also seeks to show how and why current regulations are ineffective in curbing fraud and abuse. The paper goes on to argue that, in light of the incentives incorporated into current reimbursement arrangements, physicians have to learn how to manage the conflicts they face and keep true their fiduciary responsibility to patients.

KEY WORDS
Conflict of interest, physician-patient relationship, fiduciary responsibility, fees, bias, professional journals, trust, HIPAA.