Medicine

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

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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.

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