Conflicts of Interest: can a physician serve two masters?

Conflicts of interest (COIs) exist when someone who has a fiduciary responsibility for another's welfare acts, or has the potential to act, in a manner inconsistent with their charge's best interests. COIs exist in all professions as well as in public service; however, in medicine, COIs pose a unique problem, given the responsibilities and special status that society grants to physicians. In this commentary, I explore conflicts of interest in various contexts: medical practice, continuing medical education, practice guidelines, medical journals, academic institutions and researchers, and medical professional societies and associations.

Retrospective description and analysis of consecutive catheterization laboratory ST-segment elevation myocardial infarction activations with proposal, rationale, and use of a new classification scheme.

Background: Rapid activation of a cardiac catheterization laboratory (CCL) has reduced door-to-balloon times in ST-segment elevation myocardial infarction (STEMI), leading to lower mortality. This process is accelerated with prehospital electrocardiography and notification. False activations of the CCL occur at an unknown rate and have been poorly described.

Airway management success and hypoxemia rates in air and ground critical care transport: a prospective multicenter study.

Objective: To assess critical care transport (CCT) crews' endotracheal intubation (ETI) attempts, success rates, and peri-ETI oxygenation.

Methods: Participants were adult and pediatric patients undergoing attempted advanced airway management during the period from July 2007 to December 2008 by crews from 11 CCT programs varying in geography, crew configuration, and casemix; all crews had access to neuromuscular-blocking agents. Data collected included airway management variables defined per national consensus criteria.

The American Academy of Dermatology Ethics Committee: how it works and what you need to know.

The American Academy of Dermatology Ethics Committee has a key role in assessing members' adherence to the Code of Medical Ethics. It performs no disciplinary action on its own, referring validated complaints for judicial review. The most frequent complaints that the Ethics Committee has received in recent years have been cases involving expert witness testimony, complaints about American Academy of Dermatology members promoting products and services of questionable benefit for patients through false, misleading, and deceptive advertising and self-promotion, and reports of misuse of nonphysician clinicians.