Should individuals with access to health consumers be obligated to disclose conflict of interest?

Yes. But it’s far from the standard of care.

It used to be that the only people with influence were doctors. As a consequence, doctors are held to a high standard. Now if I eat a Pfizer-sponsored doughnut at grand rounds it’s becomes part of the public record. Which I suspect is fair since I’ll do almost anything for a doughnut.

But the Internet’s great disintermediation has shifted power from the few to the many. Now there are lots of people drawing patient audiences including the patients themselves. The Internet has spawned its own cache of non-physician health care microcelebrities with big platforms and bigger opinions. Medical device makers and drug manufacturers have seized the microcelebrities and their grassroot conversations which avoids the messy reality of physicians KOLs.

Where there’s attention there’s money. And where there’s money there’s the potential for conflict.

We’ve been here before. The mommy bloggers and their ultimate reckoning with the FTC nearly a decade ago has emerged as a cautionary tale. Free cars and big cash payouts under the cover of innocent girlfriend chatter created a cottage industry rooted in conflict.

Anyone with influence is obligated to manage conflict of interest. This begins with disclosure at the point of communication. Casual mention of relationships at the bottom of an about page may cover one’s sense of obligation but fails to inform patient consumers who trust this new swath of microcelebrities.

Managing conflict isn’t just the law, it’s what we owe our patients. It’s not just for doctors anymore.

Image via mythreesisters on Flickr