Conflicts of Interest in Medical Practice and Their Costs to the Nation's Health and Health Care System

irtually all American physicians take some form of the Hippocratic oath when they graduate from medical school.And I would bet that all these newly minted doctors truly believe they will maintain the ethical conduct professed in that "oath" throughout their professional careers.Almost every medical school has modernized and changed the oath's wording from its origins on the island of Kos so many centuries ago.Nevertheless, these declarations all adhere to the essence of what the original oath assured would be the foundation of the doctor-patient relationship, that the physician would always strive to act in the patient's best interest.1 Only the rare physician admits to having deviated from this promise and when one does, it usually is after being caught doing something illegal, immoral, or both.Sadly, the reality is that today far too many physicians have violated or ignored the true meaning of the Hippocratic oath.Specifically, many, if not most, physicians practicing today have, or have had, conflicts of interest that clearly do not result in their patients' best interest.The term "conflict of interest" refers to a conflict between the private interests and the official responsibilities of an individual in a position of trust.Surely physicians function in positions of trust; in fact, the very foundation of the doctor-patient relationship rests on trust.So when and where do conflicts of interest occur most often with today's medical profession?Let's begin with the free black bags, instruments, or books given to medical students by a pharmaceutical company, or even the doughnuts, coffee, soft drinks, and free lunches provided at teaching conferences.Does accepting those gifts lead to acting in the best interest of patients?Now let's up the ante to include the free food, tickets to sporting and other events, sponsored trips to resort locales, and the shower of