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This week, top medical research center The Cleveland Clinic will announce its launch of a program to publicly report the various business dealings that each of its 1,800 staff doctors and scientists has with pharmaceutical and medical device companies.

The medical research center has promised to make complete disclosure of the financial relationships between drug companies and the center’s own doctors accessible on its website, www.clevelandclinic.org.

This is great news for patients who are concerned about the potential bias their doctors may exhibit (whether advertently or inadvertently) towards certain drugs and medical treatments because of their influential financial ties to drug companies who supplement doctor salaries in exchange for prescribing or otherwise popularizing their products.

The Cleveland Clinic says that fewer than a quarter of its doctors have anything to disclose. But Guy M. Chisolm III, the cell biologist who is chairman of the conflict-of-interest committee, says patients should know about such links so they can talk to their doctors or others at the clinic about any financial tie that raises questions.

“Patients are vulnerable,” Dr. Chisolm said. Dr. Delos M. Cosgrove, a cardiothoracic surgeon who is the Cleveland Clinic’s chief executive, takes pride in the institution’s entrepreneurial zeal and active involvement in the research and development of drugs and medical devices. But he acknowledges that the environment has changed significantly in recent years as doctors’ industry relationships have come under scrutiny.

In fact, he considers some of that scrutiny to be excessive. “You can’t get a coffee mug from a drug company,” Dr. Cosgrove said. -David Maxwell, The New York Times

While many doctors think it overkill to monitor things as seemingly petty as gifts of coffee mugs and pens from the drug reps, strong evidence suggests that even small gifts exert a powerful psychological effect on doctors’ behavior. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, has argued that even the small gifts that companies routinely doll out, such as free lunches, coffee mugs, flash drives, binders, book bags, and free samples, affect doctors’ prescribing behavior. A 2003 study Caplan coauthored and published in the American Journal of Bioethics found “indisputable [evidence] that small gifts had a tremendous power in influencing favorable attitudes toward products.”

In establishing this invaluable financial disclosure website, the Cleveland Clinic is taking an important first step in health industry self-monitoring. Hopefully the rest of the medical profession will follow suit, and ultimately make it not simply frowned upon but criminal for doctors to accept bribes from drug and medical device companies.

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