Marc A. Rodwin, “Conflicts of Interest and the Future of Medicine: The United States, France and Japan”. New York. Oxford University Press, 2011. $29.95
Most physicians would agree that the ideal doctor–patient relationship is one in which physicians provide appropriate and timely treatment — not too much, and not too little — to patients. Yet this delicate balance is extremely difficult to maintain because of the potential for conflicts of interest. Such conflicts result from insurers’ demands for high profits and from doctors’ desire to defend their primacy over insurers, hospitals, and the state. The consequences of such conflicts of interest can be devastating for the patients — and the society — stuck in the middle.
As most Americans know, conflicts of interest riddle the U.S. health care system. Yet widespread conflicts of interest are not unique to the United States. In fact, they exist in different form in virtually all advanced nations. In “Conflicts of Interest and the Future of Medicine,” Marc A. Rodwin examines the development of these conflicts in the United States, France and Japan. As he shows, the variations in the type and prevalence of such conflicts are a product of the national differences in the organization of medicine, insurance and public policy. Rodwin then analyzes the unique 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 as Rodwin demonstrates, it is possible to mitigate these problems with carefully planned reform and regulation. Drawing on the experiences of these three nations, Rodwin looks at the effectiveness of measures taken in the private and public centers to preserve medical professionalism — and concludes that there just might be more than one prescription to this seemingly incurable malady.