Robert Yokl on Conflicts of Interest

A recent Carnegie Mellon University study found that doctors see the gifts (pens, free lunches, equipment, consulting fees and honorariums, etc.) they have been receiving from drug companies and orthopedic manufacturers as paybacks for all the pain, heartache and toil they have endured over the years to become doctors. 

More importantly, they see these gifts as “barely disguised bribes”, even though other studies show that they do influence how they treat their patients and conduct research.  “The conclusion to the study was that physicians are going to find a way to rationalize accepting these bribes as long as they are offered and are legal,” says George Loewenstein, professor of economics and psychology, the studies supervisor.

I bring this topic up because I just wrote a “code of ethics” policy and procedure* for a healthcare system we are working with that includes a “conflicts of interest” clause that  mandates that no employees and medical staff may accept gifts or gratuities of any sort from any existing or prospective vendor. Further, all employees and medical staff are required to promptly report and make full disclosure, in writing, of a possible existence of a conflict of interest for themselves or others with an existing or prospective vendor.


More and more, hospitals, systems and IDNs are creating “conflicts of interest” policies for their employees and medical staff since they realize that their patients’ welfare, integrity and financial stability are at risk. No longer can doctors receive $1 million or more in consulting or royalty payments from drug or orthopedic device companies without disclosing this fact to the healthcare institutions they work for or which they practice their trade.

As I have already suggested, the first step in winning this battle is for your healthcare organization to have a strong, unyielding and uncompromising “conflicts of interest” policy and procedure that has teeth in it: If it is compromised in any way your healthcare organization must be ready to fire, discharge or cancel the contract of the individual (doctor or otherwise) without blinking an eye.

This tough love is necessary since, as I mentioned previously, most doctors rationalize that accepting gifts is OK unless there is a legal penalty to be paid for doing so. And half-of these physicians who are making more then $1 million in consulting fees don’t even mention this fact in their scientific articles. This is the dirty little secret that now has been exposed by numerous studies and media expose. This practice must be stamped out by our healthcare industry in this age of transparency, accountability and healthcare reform, if we are ever to be seen as truly trustworthy in our patient’s eyes.


* If you would like a copy of this “Code of Ethics” policy and procedure I just talked about, just e-mail me at and I will promptly e-mail it to you.

Robert T. Yokl is Chief Value Strategist, Strategic Value Analysis® in Healthcare

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