(p. A15) The reality of modern medicine, Dr. Stossel argues, is that private industry is the engine of innovation, with productivity and new advances dependent on relationships between commercial interests and academic and research medicine. Companies, not universities or research with federal funding, run 85% of the medical-products pipeline. “We all inevitably have conflicts all the time. You only stop having conflicts when you’re dead. The only conflict-free situation is the grave,” he says.
The pursuit of the illusion “to be pure, to be priestly, to be supposedly uncorrupted by the profit motive,” Dr. Stossel says, often has the effect of banishing or else discounting the expertise of the people who know the most but whose integrity and objectivity are allegedly compromised by industry ties. What ought to matter more, he adds, is simply “Results. Competence. LeBron James–it’s putting the ball in the basket.”
. . .
Zero-tolerance conflict-of-interest editorial policies, Dr. Stossel says, suppress and distort debate by withholding positions of authority. “If you have an industry connection, if you really understand the topic, you can’t say anything,” he notes. “If you’re an editor, and you have an ideological predilection, you have all this power and you can say anything you want.”
Dr. Stossel is equally scorching about the drug and device companies and their trade organizations, which he says drift around like Rodney Dangerfield, complaining they don’t get no respect. They prefer not to be confrontational, they rarely fight back against the conflict-of-interest scolds. “They’re laying responsibility by default to the patients, the people who actually have a first-hand connection to whatever the disease is: ‘Goddammit, I want a cure.’ ”
Which is the larger point: The to-and-fro between publications not meant for lay readers can seem arcane, but the product of conflict-of-interest politics is fewer cures and new therapies. The predisposition against selling out to industry is pervasive, while reputations can be ruined overnight when researchers find themselves in a page-one exposé or hauled before Congress, even if there is no evidence of misconduct or bias.
Better, then, to conform in the cloisters than risk offending the conflict-of-interest orthodoxy–or translating some basic-research insight into a new treatment for patients. Dr. Rosenbaum reports: “The result is a stifling of honest discourse and potential discouragement of productive collaborations. . . . More strikingly, some of the young, talented physician-investigators I spoke with expressed worry about how any industry relationship would affect their careers.”
. . .
‘Pharmaphobia”–part polemic, part analytic investigation, a history of medicine and a memoir–deserves a wide readership. . . . “I’d rather get a conversation started with people who are smarter than I am about how complicated and granular and nuanced and unpredictable discovery is. Let’s not slow it down.”
For the full interview, see:
JOSEPH RAGO. “The Weekend Interview with Tom Stossel; A Cure for ‘Conflict of Interest’ Mania; A crusading physician says medical progress is hampered by a holier-than-thou ‘moralistic bullying.’.” The Wall Street Journal (Sat., June 27, 2015): A15.
(Note: ellipses added.)
(Note: the online version of the interview has the date June 26, 2015, and has the title “A Cure for ‘Conflict of Interest’ Mania; A crusading physician says medical progress is hampered by a holier-than-thou ‘moralistic bullying.’.”)
The book mentioned in the interview, is:
Stossel, Thomas P. Pharmaphobia: How the Conflict of Interest Myth Undermines American Medical Innovation. Lanham, MS: Rowman & Littlefield Publishers, 2015.