When asked my opinion in the 1980s during the first major wave of physician and hospital center partnerships, I felt it was good for the industry, and good for the patient. However, as time would tell, it resulted in an oversupply of outpatient centers that took much-needed revenue away from cost-ridden community medical centers. Outpatient services had become the most profitable sector of hospital departments. At its worst were issues of financial conflict of interest from self-referrals to centers where the physician held a financial interest. On occasion, such conflicts did "cloud" sound judgment.
Today, we face a new type of threat from physician and health care infrastructure relationships, which raises conflicts of interest at the core scientific level. We already have unresolved issues and critical debate on conflicts between the FDA and the industry it oversees. I suggest that before we embark on an escalation of physician, corporate infrastructure, and health agency partnerships, we first address the conflicts of interest that today compromise the science of what we do. Ultimately, the best barometer of the success of a partnership, is a satisfied "patient" customer.