On a national level and on an international level, medical specialities are a very small community. People become known through their conference presentations, academic positions, journal publication and so forth. Often, medical specialists have to ‘wear two hats’. On one hand, they do independent research in their area of interest. On the other hand, they consult with drug companies in their speciality. The delicate balance is to be transparent in these relationships and to avoid any conflict of interest. Apparently, this balance allegedly has been disrupted severely:
“One of the nation’s most influential psychiatrists earned more than $2.8 million in consulting arrangements with drug makers from 2000 to 2007, failed to report at least $1.2 million of that income to his university and violated federal research rules, according to documents provided to congressional investigators.”
Not only must a conflict of interest to avoided, the medical specialist must guard against a perception of impropriety. The present payment data uncovered raise questions about objectivity and calls into doubt years of scientific inquiry. Simply, the situation is an utter mess – and many of the scientific medical conclusions may need to be re-examined and re-evaluated.