The Medical Conflict of Interest Mania: Dr. Thomas Stossel on Regulating Doctors


If the real-world consequences weren't so severe, Dr. Thomas Stossel's favorite anecdote would be a forgettable joke, instead of an unfortunate comment on the current practice of medicine.

The anecdote goes like this:

An enterprising reporter is writing a story about medical conflict of interest. He approaches Dr. Stossel, who's been extolling the benefits of a drug invented by Pfizer.

"I see, Dr. Stossel, you got $2,000 from Pfizer!"

"Yeah, it's because I add value," replies Stossel. "If I didn't, I'd be a reporter."

Dr. Stossel tells the joke, not with a smile, but with a weary glower of frustration. He is, after all, describing an uphill battle, fought against the mainstream media and his fellow doctors, that has occupied a significant part of his working life. It is the task of convincing the public that medical conflict of interest laws are hurting the practice of medicine.

Stossel knows a few things about the intersection of medicine and money. He's the American Cancer Society professor of medicine at Harvard Medical School and an accomplished researcher of cellular biology. He spoke at Reason Weekend in St. Petersburg, Florida, to deliver a contrarian take on a subject that has drawn national media attention: the excessive regulation of financial arrangements between physicians and the pharmaceutical industry.

Stossel cites the unintended consequences of legislation like the Physician Payments Sunshine Act, which was enacted as part of Obamacare. Greater transparency in medical care may seem like a worthy goal, but only when its supporters fail to account for the full cost of the law. The legislation, he says, is "300 pages of legal gibberish," which mandates disclosure of payments as low as $10 to doctors. Billions of dollars every year will be spent on compliance with these regulations – money that will be diverted away from medical research that improves our lives.

Over the last ten years, new legal strategies based on charges of "false claims" are used to comply with the law or pressure companies to quickly settle lawsuits. Underlying these accusations is the threat of debarment, a set of harsh financial penalties, which Stossel describes as, "arguably the most damaging aspect of the conflict of interest mania."

Above all, Stossel hopes to discredit allegations that the for-profit medical industry is fundamentally criminal. He argues that marketing practices employed by pharmaceutical companies do not distort physicians' ability to discern fact from fiction. On the contrary, marketing can encourage doctors to learn about the latest developments in medicine. In the absence of conflict of interest regulation, researchers were better rewarded for successful drug development. Steady declines in rates of mortality from cancer, heart disease, and HIV-AIDS over the last decades would not have occurred if financial arrangements were as corrupting a force as critics have charged.

Having spent much of the last ten years trying to persuade people otherwise, today Dr. Stossel is pessimistic about the future of medical conflict of interest regulations. "We've been wimps, especially the industry," he says of a medical establishment that's afraid to stand up for its own interests as well as the public good.

As a result, Stossel's message has struggled to gain traction against an army of what he calls "instigators" (well-meaning activists) and "enablers" (institutional authorities). Yet he continues to lecture to the public, speak before Congress, and write opinion articles, hoping that a solution may someday arise from the general public.

Runs about 31 minutes.

Produced by Todd Krainin. Cameras by Paul Feine and Zach Weismueller.

Scroll down for downloadable versions and subscribe to ReasonTV's YouTube Channel to receive notification when new material goes live.

NEXT: Adam Carolla on Patent Trolls, the Government, NPR, Salon, and More!

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  1. And yet, Chemo and Radiation seem to be the only things prescribed by Doctors for cancer. We have court cases where Doctors sue to remove the right of the patient to choose, thus forcing the patient to take the treatment the drug companies have compensated the doctor for "adding value" to.

    Ask your doctor how many people have had a negative experience/reaction taking drug "X". Do not be surprised if he/she makes you feel they have no idea. And yet, he/she is prescribing it to you. Is it really "bad" for me to know that a drug company has paid my doctor to prescribe this drug to me?

  2. Have I mentioned I like Stossel?

    1. I was waiting for this.

  3. Maybe, just maybe, this wouldn't be any issue at all if you didn't have licensing of doctors or a prohibition of drugs? Why do I have the sneaking suspicion that this guy is all in favor of those types of regulations?

    1. Ding ding ding! We have a winner!

      Doctors make their money through the monopoly power of their guild, granted and enforced by government guns.

      "Above all, Stossel hopes to discredit allegations that the for-profit medical industry is fundamentally criminal. "

      Good luck. You're a shakedown racket enabled by government guns. Support a patient's right to buy medical services from whoever he wants, and I'll consider worrying about your government paperwork problem.

      1. Doctors make their money through the monopoly power of their guild, granted and enforced by government guns.

        Like all true monopolies, it wouldn't be possible without political coercion.

  4. I worked as a sales rep in the medical device industry for the largest companies, and some small start-ups. Selling unique devices like Heart Valves, Pacemakers, etc. The government's lack of faith in Physicians is breathtaking. These are highly educated, well paid, people who, more than any other industry, have government watching every thing they do. The government has strong-armed the Device companies to start ADVAMED which only allows certain kinds of contact with a doctor and can only spend $100-$120 on dinner, you can't play golf even if you pay your own way, you can't put them up in a luxury hotel even if the rate is cheap... Why are politicians allowed to be taken to an expensive steak dinner by a lobbyist ? Why is a banker allowed to fly on another banker's corporate jet to do business? What's the difference? Meanwhile the DOJ is threatening companies for "off-label" promotion...threatening jail time and massive multi-million dollar fines.

    I was fortunate enough to be in thousands of procedures, and by the end of my career, act as a proctor, training a physician onlife saving devices. we would work as a team: rep knowing the product, the physician knowing the disease and the surgery...and together people's lives were saved. To demonize the miracles that are produced by the US med device industry (or drugs) is insane. The pace of innovation has slowed...and will get worse due to all the regulations. That next miracle won't come as a result.

    1. So, you think Docs are not human beings and don't respond to being incentivized by Big Pharma to promote drugs which operate a few percentage points above placebo (and add other dangers and side effects)???

      The stories are well known. Big Pharma takes your and my money and takes these docs on junkets, hires them to give one sided presentations to other docs and pretty much buys them off.

      Docs are no different in terms of incentives than the street corner H dealers. Pay them enough (a large enough percentage of them) will do or say just about anything.

      I know many a doc who has no idea where their retirement is coming from - they ask ME how I do it! If Big Pharma or Big Medical Device comes along and offers them some sweet candy, they will very quickly talk themselves into it. After all, many of these things aren't black and white. A moral person could talk themselves into promoting the newest SSRI even though it's only 34% effective compared to 29% for sugar pills.

      It's a slow drip-drip-drip of influence.

      Also, look up the stats on how many docs are drug addicted. I personally know of two who went off the deep end - one a surgeon. He became homeless and addicted....and, now, he's doing even better as a expert witness in court cases!

      The Gugments lack of faith in ANYONE is quite justified. Our system corrupts people - predatory. They can always find people who will sell out.

      1. I'm willing to sell out. Why won't anyone make me an offer?

        1. Your skills are not valuable in the "free market"...

      2. Don't piss off the person handling your food is a time tested piece of good advice.

        You'd think people would understand that not pissing off the people putting your guts back together is just as important.

  5. its amazing..... Start working at home with Google. It's a great work at home opportunity. Just work for few hours. I earn up to $100 a day. I can't believe how easy it was once I tried it out

  6. This is just about the ultimate distortion of the reality. Anyone who looks past the media propaganda machine and the hype of the medical orthodoxy will find that the American Cancer Society is buried in conflicts of interest and are merely a marketing instrument for the big business of orthodox medicine disguised as a "charity" ( read thru this: http://www.supplements-and-hea.....ogram.html ).
    Once you have that understanding you'll see clearly why Stossel is arguing against "conflict of interest laws" with spurious rhetoric and false statements -i.e., lies. He's just a hack deceiving the public, exactly what the American Cancer Society has been doing for decades.

Please to post comments

Comments are closed.