Financial conflicts of interest in health care are rampant. In 2015, almost half (48%) of all doctors in the US received some kind of payment from the drug or medical device industry. Over the past five years, more than 700 doctors received a million dollars or more from industry. Financial conflicts affect doctor prescribing habits, the creation of clinical practice guidelines, the policy positions of patient advocacy groups, how health news is reported, and more. It is not an overstatement to say that drug and device industry funding influences every aspect of the health care system.
In the midst of this epidemic of financial conflicts, a meeting to discuss this issue frankly would be welcome. So when the NYU Grossman School of Medicine announced their upcoming conference on conflicts of interest in health care, featuring several well-known outspoken clinician speakers, it seemed like the perfect opportunity to translate research on conflicts into action.
But there’s one big problem: The conference is sponsored by Johnson & Johnson, a huge manufacturer of both medical devices and pharmaceuticals. Additionally, Sandra Morris, J&J’s vice president of strategy realization, is on the organizing committee for the event.
The irony of a conflict of interest conference being funded and co-organized by industry has not gone unnoticed. “This is a conflict of interest conference with a conflict of interest,” said Dr. Adriane Fugh-Berman, professor at Georgetown University and director of the PharmedOut project, in an interview with STAT News. “It should be antithetical to their purpose to accept industry funding in order to discuss a topic of such major financial importance to that industry.”
Why have industry at the meeting? Dr. Arthur Caplan, one of the meeting organizers and head of the Division of Medical Ethics at the New York University Langone Medical Center, said that having a variety of views on conflicts makes for a more exciting and fruitful discussion. “My view is to invite a lot of parties and let them go at it,” he said, in STAT.
However, there is big difference between inviting an industry representative to be on a panel at a conference and having industry underwrite and organize the conference. You don’t need to put industry at the wheel of the whole event to “include” them.
By putting J&J in charge, NYU is giving them a wide open opportunity to push the idea that it’s not only financial conflicts of interest that are bad, but also ideological conflicts of interest. Industry would like people to believe that having an “intellectual bias” is just as harmful as receiving money from industry. The conference organizers seem to support this reframing. According to STAT, the conference invitation to potential panelists read that “all participants are susceptible to financial or ideological conflict of interest.”
This narrative that having preconceived ideas about a topic is on par with a financial relationship with industry is dangerous for many reasons. First, it paints conflicts of interest as too complex to solve (how can you root out all “intellectual bias?”). Second, it provides a base for industry to try to change laws around conflicts of interest to equate “intellectual” conflicts with financial ones, which would make financial conflicts nearly impossible to regulate.
As Upton Sinclair famously said, “It is difficult to get a man to understand something when his salary depends upon his not understanding it.” Until these types of events are free from industry funding, the organizers will fail to understand the depth of harm that financial conflicts of interest cause in health care.