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Letters
JAMA. 2006;295(24):2846-2847. doi: 10.1001/jama.295.24.2846-b

Academic Medical Centers and Conflicts of Interest

  1. Roy M. Poses, MD
  1. rposes@firmfound.org
    Foundation for Integrity and Responsibility in Medicine
    Warren, RI
  1. Scot Silverstein, MD
  1. Institute for Healthcare Informatics
    Drexel University
    Philadelphia, Pa
  1. Wally R. Smith, MD
  1. Department of Internal Medicine
    Virginia Commonwealth University
    Richmond

Since this article does not have an abstract, we have provided the first 150 words of the full text.

To the Editor: The Special Communication by Dr Brennan and colleagues1 effectively reviews how physicians' conflicts of interest provide challenges to their professionalism. However, we believe that the focus was too narrow and the proposed solutions were incomplete and possibly misguided.

Brennan et al implied that the only important conflicts of interest are those involving individual physicians and pharmaceutical or device manufacturers. However, conflicts posed by physicians' relationships with managed care may be just as important. Dr Kassirer, one the coauthors, has elsewhere written that “market driven health care creates conflicts that threaten medical professionalism.”2

Conflicts of interest permeate health care, affecting not only physicians but also other health care decision makers, particularly the leaders of large organizations.3 A survey of the American College of Physician Executives (21% response rate) found that 66% of respondents were concerned about conflicts of interest affecting nonphysician leaders of health care …

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