While the new healthcare reform law will require all drug and device makers to report payments to physicians in a searchable public database by 2013, Rothman says it will not necessarily solve the problem unless journal editors use the information and physicians make full disclosures.
Using a top-down approach—by getting leading medical education institutions and the leading professional medical societies to really start emphasizing and using the data in and around conflict of interest—is one way "that this would be cost-effectively done" in the future, Rothman says.
Also, the emphasis on avoiding conflict-of-interest can start in the early years. "When I lecture medical students here at Columbia and talk about this subject, I tell them...[to] understand that from the very beginning, every dollar that [they] take—from a device or drug company—will be public information. It's a very different orientation," he says.
In a separate study on conflict-of-interest that appears this week in the Journal of the American Medical Association (JAMA), researchers found that some resident physicians rationalized that they were comfortable accepting gifts—because they had made sacrifices and they were "worthy of that treatment."
No physicians took any gifts in this study, said co-author, Sunita Sah, who is a former practicing physician who once consulted for pharmaceutical companies on sales and marketing to physician.