Conflict of interest disclosure: striking a balance?

Defensive medicine in Europe: a ‘full circle’?

“…Healthcare is a classical example of 'market failure' in economic theory, since health is a 'merit good' rather than a common 'consumer good' [49]. Therefore, competition is not the best instrument for addressing equity concerns, and an 'Americanization' of health, with high prevalence of private for-profit 'players' (for both funding and provision), is hardly recommendable: not by chance has the USA skyrocketing healthcare expenditure and spends far more than other wealthy nations for administration [50].…”

“…If medicine is firstly a mission aimed at serving patients as often recalled in the medical literature clinical practice should be mainly inspired by collaboration among health professionals, and financial incentives should be considered very arguable means for making them work better for patients [51]. If patients' interests are the cornerstone of physicians' fiduciary relationship with them, success in curing or caring should be the leading motivation for physicians, and business ethics should not be mixed with medical ethics to avoid undermining physician-patient trust [49]. Ideally, there is no doubt that an organizational culture rooted in teamwork and collaboration fits healthcare services much better than a competitive one.…”

Defensive medicine in Europe: a ‘full circle’?

“…Once agreed that DM is a sort of unnecessary and expensive 'side effect' of modern medicine, to be deterred, rather than an objective problem to be tackled, some general recommendations stemming from economics and business administration can be raised to limit the threat. Healthcare is a classical example of 'market failure' in economic theory, since health is a 'merit good' rather than a common 'consumer good' [49]. Therefore, competition is not the best instrument for addressing equity concerns, and an 'Americanization' of health, with high prevalence of private for-profit 'players' (for both funding and provision), is hardly recommendable: not by chance has the USA skyrocketing healthcare expenditure and spends far more than other wealthy nations for administration [50].…”

Pricing vaccines and drugs in Europe: worth differentiating?

“…In a typical 'market failure' situation like pharmaceuticals, physicians (working as the patient's agent) fill the information gap of patients in medicine and take on their behalf the final decisions about how many and which drugs to prescribe among those available [14]. Hence, as prescribers, physicians are conventionally the major marketing target of pharmaceutical companies and aggressive strategies may raise financial conflicts of interest [15], eventually leading to drug overconsumption and bribery.…”