Conflicts of Interest and the Future of Medicine: The United States, France, and Japan

Marc A. Rodwin

Feb 2011 · Oxford University Press

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As most Americans know, conflicts of interest riddle the US health care system. They result from physicians practicing medicine as entrepreneurs, from physicians' ties to pharma, and from investor-owned firms and insurers' influence over physicians' medial choices. These conflicts raise questions about physicians' loyalty to their patients and their professional and economic independence. The consequences of such conflicts of interest are often devastating for the patients--and society--stuck in the middle. In Conflicts of Interest and the Future of Medicine, Marc Rodwin examines the development of these conflicts in the US, France, and Japan. He shows that national differences in the organization of medical practice and the interplay of organized medicine, the market, and the state give rise to variations in the type and prevalence of such conflicts. He then analyzes the strategies that each nation employs to cope with them. Unfortunately, many proposals to address physicians' conflicts of interest do not offer solutions that stick. But drawing on the experiences of these three nations, Rodwin demonstrates that we can mitigate these problems with carefully planned reform and regulation. He examines a range of measures that can be taken in the private and public sector to preserve medical professionalism--and concludes that there just might be more than one prescription to this seemingly incurable malady.

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Marc A. Rodwin is Professor of Law at Suffolk University Law School. He is the author of Medicine, Money amd Morals: Physicians' Conflicts of Interest (OUP 1993) and numerous articles on health law, ethics, politics and policy. Rodwin has been a research scholar at Tokyo University Law School and the Centre National de Recherche Scientifique in France. He has testified before Congress, advised consumer groups, and lectured in several countries.