CONFLICTS OF INTEREST AND THE FUTURE OF MEDICINE. THE UNITED STATES, FRANCE, AND JAPAN

Forward by Jerome Kassirer
Framing the Issues
Introduction: Patient Stories
1. The Heart of the Matter. Case Studies
2. The Evolution of the French Medicine
3. Coping with Physicians' Conflicts of Interest in France
4. The Rise of a Protected Medical Market: The United States before 1950
5. The Commercial Transformation: The United States, 1950-1980
6. The Logic of Medical Markets: The United States, 1980 to the Present
7. Coping with Physicians' Conflicts of Interest in the United States
8. The Evolution of Japanese Medicine
9. Coping with Physicians' Conflicts of Interest in Japan Implications
10. Reforms
11. Professionalism Reconsidered
Conclusion: The Way Forward
Appendix: Conflicts of Interest Ideas: Origins and Application to Physicians
Acronyms and Glossary
Acknowledgements
About the Author
Bibliography
Index

As most Americans know, conflicts of interest riddle the US health care system. They result from physicians practicing medicine as entrepreneurs, from physicians' ties to pharma, and from investor-owned firms and insurers' influence over physicians' medial choices. These conflicts raise questions about physicians' loyalty to their patients and their professional and economic independence. The consequences of such conflicts of interest are often devastating for the patients—and society—stuck in the middle.

In Conflicts of Interest and the Future of Medicine, Marc Rodwin examines the development of these conflicts in the US, France, and Japan. He shows that national differences in the organization of medical practice and the interplay of organized medicine, the market, and the state give rise to variations in the type and prevalence of such conflicts. He then analyzes the strategies that each nation employs to cope with them.

Unfortunately, many proposals to address physicians' conflicts of interest do not offer solutions that stick. But drawing on the experiences of these three nations, Rodwin demonstrates that we can mitigate these problems with carefully planned reform and regulation. He examines a range of measures that can be taken in the private and public sector to preserve medical professionalism—and concludes that there just might be more than one prescription to this seemingly incurable malady.

Features
• Puts the systemic weaknesses of the US health care system in global perspective.
• First book to compare the effectiveness of strategies used to address conflicts of interest and to propose reforms based on assessment of what works and what doesn't in several countries
• Examines in detail an area of key public concern: conflicts of interest arising from physician ties to drug firms and other commercial interests.

Author
Marc A. Rodwin is Professor of Law at Suffolk University Law School. He is the author of Medicine, Money amd Morals: Physicians' Conflicts of Interest (OUP 1993) and numerous articles on health law, ethics, politics and policy. Rodwin has been a research scholar at Tokyo University Law School and the Centre National de Recherche Scientifique in France. He has testified before Congress, advised consumer groups, and lectured in several countries.