Industry-physician relationships: a call for greater distance. Catholic health care systems need to join others in adopting stricter guidelines.

BY MICHAEL R. PANICOLA, Ph.D., & RON HAMEL, Ph.D. From top, Dr. Panicola is corporate vice president, ethics, SSM Health Care, and Dr. Hamel is senior director, ethics, Catholic Health Association, both in St. Louis. J P hysicians have long been committed to promoting the best interests .JSk»_ of their patients, ensuring scientific integrity in research, and making treatment decisions free of bias. These are the ethical foundations of the profession. Yet these very foundations are threatened today by the extensive involvement of pharmaceutical, device and other medically related companies (hereafter, "industry") with physicians. Currently, industry supports more than half of all continuing medical education, sponsors 70 percent of all privately funded clinical research and interacts frequently with and provides various financial enticements to physicians. While industry's involvement in health care and with physicians has helped advance medicine and has benefited patients, its ultimate responsibility is to shareholders who expect a return on investment. Much of industry's activity is geared toward this end, including its relationships with physicians. To be clear, industry-physician relationships not only affect the medical profession but also have far-reaching implications for all those who use and take part in the American health care delivery system. The issue has special relevance for health care organizations insofar as the credibility of such organizations is tied up with the physicians who practice within and/or in the name of these organizations. As such, health care organizations need to be attentive to this issue and act accordingly to curb real or perceived financial conflicts of interest engendered by industry's involvement with physicians. Catholic health care, in particular, should be especially concerned and quick to take corrective action, given its mostly counter-cultural stance vis-a-vis with the market and its commitments to integrity and the common good.