Overview

As most Americans know, conflicts of interest riddle the US health care system. They result from physicians practicing medicine as entrepreneurs, from physicians' ties to pharma, and from investor-owned firms and insurers' influence over physicians' medial choices. These conflicts raise questions about physicians' loyalty to their patients and their professional and economic independence. The consequences of such conflicts of interest are often devastating for the patients--and society--stuck in the middle. In Conflicts of Interest and the Future of Medicine, Marc Rodwin examines the development of these conflicts in the US, France, and Japan. He shows that national differences in the organization of medical practice and the interplay of organized medicine, the market, and the state give rise to variations in the type and prevalence of such conflicts. He then analyzes the 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 drawing on the experiences of these three nations, Rodwin demonstrates that we can mitigate these problems with carefully planned reform and regulation. He examines a range of measures that can be taken in the private and public sector to preserve medical professionalism--and concludes that there just might be more than one prescription to this seemingly incurable malady.

Full Product Details

Author:   Marc A. Rodwin (Professor of Law, Professor of Law, Suffolk University)
Publisher:   Oxford University Press Inc
Imprint:   Oxford University Press Inc
Dimensions:   Width: 23.60cm , Height: 3.10cm , Length: 16.50cm
Weight:   0.646kg
ISBN:  

9780199755486

ISBN 10:   0199755485
Pages:   392
Publication Date:   31 March 2011
Audience:   General/trade ,  General
Format:   Hardback
Publisher's Status:   Active
Availability:   To order  
Stock availability from the supplier is unknown. We will order it for you and ship this item to you once it is received by us.

Table of Contents

Table of Contents Forward by Jerome Kassirer Framing the Issues Introduction: Patient Stories 1. The Heart of the Matter Case Studies 2. The Evolution of the French Medicine 3. Coping with Physicians' Conflicts of Interest in France 4. The Rise of a Protected Medical Market: The United States before 1950 5. The Commercial Transformation: The United States, 1950-1980 6. The Logic of Medical Markets: The United States, 1980 to the Present 7. Coping with Physicians' Conflicts of Interest in the United States 8. The Evolution of Japanese Medicine 9. Coping with Physicians' Conflicts of Interest in Japan Implications 10. Reforms 11. Professionalism Reconsidered Conclusion: The Way Forward Appendix: Conflicts of Interest Ideas: Origins and Application to Physicians Acronyms and Glossary Acknowledgements About the Author Bibliography Index

Reviews

Superb, comparative, fascinating ... A valuable historical study which is also a major contribution to conflict of interest debates in US and international health care policy, suggesting practical alternatives for the future. Rosemary A. Stevens, Distinguished Scholar, Weill Cornell Medical College-New York City Rodwin turns a critical eye to the current proposals ... suggests new directions for reform ... [and] offers important advice that policy makers must heed if we are to restore trust in our profession. Jerome P. Kassirer, MD, Distinguished Professor, Tufts University School of Medicine, and Editor-in-Chief Emeritus of New England Journal of Medicine A wise, powerful, broad-ranging guide to saving the relationship between doctors and patients. Conflicts of Interest is meticulously researched and beautifully written. It explores the past, illuminates the present, and points us toward a promising future. We ignore Marc Rodwin at our peril. James Morone, Professor of Political Science and Urban Studies, Brown University, co-author of The Heart of Power and author of Hellfire Nation Rodwin, whose earlier classic on medical conflicts of interest contributed importantly to the public debate, has deepened his analysis in a comparative perspective ... He again enlarges and enlightens the debate and offers useful policy alternatives. David Mechanic, Director of the Institute for Health, Health Care Policy, and Aging Research, Rutgers University This book specifies the ways in which both government and medical professionals and organizations must change if we are to adequately protect patients. Rodwin's analysis is thoughtful and thorough; his recommendations can help guide us to more effective public policies. Thomas Rice, Professor of Health Services, University of California-Los Angeles School of Public Health A fitting sequel to Rodwin's pathbreaking Medicine, Money, and Morals. His analysis of conflicts of interest in medicine in France, Japan, and the US is both fascinating and sensible. Timothy Stoltzfus Jost, Professor of Law, Washington and Lee University School of Law The medical profession, the market, and the state exist in a delicate and dynamic balance. By explaining how this balance is maintained or lost in three countries, Rodwin is able to diagnose the ills of American medicine and suggest appropriate treatment. John D. Lantos, MD, Professor of Pediatrics, University of Missouri, and author of Do We Still Need Doctors?

The existence of these incentives-and the conflicts of interest they create-is the subject of Marc Rodwin's new book, Conflicts of Interest and the Future of Medicine. In his history-heavy analysis of the growth and symbiosis of medicine and industry in the United States, France, and Japan, Rodwin chronicles the cultural, legal, and institutional factors that have contributed to each country's current landscape of financial incentives in clinical medicine. Each tells a different story of how organized medicine, professional self-regulation, market competition, and payers affect contemporary physician behavior and provides insight into the relationship between this behavior and health care cost. Adam Licurse and Aaron S. Kesselheim, Journal of Bioethical Inquiry Dr. Rodwin masterfully reviews most of the reasons leading to conflicts-of- interest and draws attention to the similarities and differences between the United States', Japan's, and France's practices for managing this problem. He presents relevant examples, discusses the historical evolution of the medical ethics in each country, and proposes suitable remedial actions ... This is a well-written and scholastic treatise by an academic who studied and worked in all three countries discussed in this book. Arnauld Nicogossian, World Medical & Health Policy offers us deeper insights into the complexity of interests that impact in doctors' decisions beyond medical reasons and that may not always benefit patients and the public interest ... Rodwin provides comprehensive, yet accessible information on the complexity of conflicts of interest and how they may shape the future of medicine in different health-care systems. This book is well written and highly topical. It will be of interest for all those who are concerned about doctors' conflicts of interest, from policymakers and academics to practitioners and the users of medical services. Ellen Kuhlmann, Social Policy & Administration Rodwin provides significant context for the ongoing debate over health care policy... Of particular interest to American readers are the chapters on the role of markets, including the commercialization of the American medical economy. Rodwin provides broad, well-documented coverage of financing mechanisms and the competing goals of state and markets. F. W. Musgrave, Choice: Social & Behavioral Sciences [Conflicts of Interest anf the Future of Medicine] will be helpful to scholars as well as intriguing to readers new to the subject. Samuel Y. Sessions, JAMA Rodwin has written an important book on an urgent topic, neglected by both political parties in the ongoing battle over health care reform. M Gregg Bloche, Health Affairs This is a fine piece of work that will be of great use particularly to historians of twentieth century medicine. Nancy Tomes, Social History of Medicine Advance Access Marc Rodwins Conflicts of Interest and the Future of Medicine succeeds admirably both at helping us learn about other countries and at helping us learn from them The attentive reader will come away from these chapters with a sophisticated and complex understanding of the evolution of the healthcare financing system in each of the countries.The book will be of great interest to health policy analysts, health lawyers, physician leaders, regulators, and bioethicists. It is a model of descriptive and analytical comparative analysis... Rodwin pulls no punches, announcing that the experiences of the three countries have led him to conclude that a number of traditional reforms aimed at conflict of interest in medicine just dont workRodwin supplies detailed arguments for each conclusion, based on the evidence gathered in his national case studies. Stephen R. Latham The American Journal of Bioethics Superb, comparative, fascinating ... A valuable historical study which is also a major contribution to conflict of interest debates in US and international health care policy, suggesting practical alternatives for the future. Rosemary A. Stevens, Distinguished Scholar, Weill Cornell Medical College-New York City Rodwin turns a critical eye to the current proposals ... suggests new directions for reform ... [and] offers important advice that policy makers must heed if we are to restore trust in our profession. Jerome P. Kassirer, MD, Distinguished Professor, Tufts University School of Medicine, and Editor-in-Chief Emeritus of New England Journal of Medicine A wise, powerful, broad-ranging guide to saving the relationship between doctors and patients. Conflicts of Interest is meticulously researched and beautifully written. It explores the past, illuminates the present, and points us toward a promising future. We ignore Marc Rodwin at our peril. James Morone, Professor of Political Science and Urban Studies, Brown University, co-author of The Heart of Power and author of Hellfire Nation Rodwin, whose earlier classic on medical conflicts of interest contributed importantly to the public debate, has deepened his analysis in a comparative perspective ... He again enlarges and enlightens the debate and offers useful policy alternatives. David Mechanic, Director of the Institute for Health, Health Care Policy, and Aging Research, Rutgers University This book specifies the ways in which both government and medical professionals and organizations must change if we are to adequately protect patients. Rodwin's analysis is thoughtful and thorough; his recommendations can help guide us to more effective public policies. Thomas Rice, Professor of Health Services, University of California-Los Angeles School of Public Health A fitting sequel to Rodwin's pathbreaking Medicine, Money, and Morals. His analysis of conflicts of interest in medicine in France, Japan, and the US is both fascinating and sensible. Timothy Stoltzfus Jost, Professor of Law, Washington and Lee University School of Law The medical profession, the market, and the state exist in a delicate and dynamic balance. By explaining how this balance is maintained or lost in three countries, Rodwin is able to diagnose the ills of American medicine and suggest appropriate treatment. John D. Lantos, MD, Professor of Pediatrics, University of Missouri, and author of Do We Still Need Doctors?

Author Information

Marc A. Rodwin is Professor of Law at Suffolk University Law School. He is the author of Medicine, Money amd Morals: Physicians' Conflicts of Interest (OUP 1993) and numerous articles on health law, ethics, politics and policy. Rodwin has been a research scholar at Tokyo University Law School and the Centre National de Recherche Scientifique in France. He has testified before Congress, advised consumer groups, and lectured in several countries.

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