Monday, September 20, 2010

Thomas Jefferson and financial conflicts of interest

the Egyptian Building
While reading Peter Orszag's excellent column on the role that rising medical costs have had on the declining state-funding of state universities, I came across an interesting historical example of medical conflicts of interest.  Initially, I was trying to determine the public/private status of Mike's institution, Virginia Commonwealth University, when I learned about Augustus Warner and Thomas Jefferson.

In 1837, Dr. Augustus Warner, a surgeon at University of Virginia and graduate of the University of Maryland, became disillusioned with the clinical material available and felt that Richmond would provide a much broader patient base, so he started and became Dean of what was to become the Medical College of Virginia (VCU). Most interestingly, Dr. Warner was said to have left the University of Virginia’s medical school because he didn't agree with Thomas Jefferson’s philosophy that professors shouldn’t corrupt their teaching by making money caring for patients.

I guess I can imagine that physicians enrolling patients in RCTs might have conflicts between science and their patients (hence blinding and perhaps random assignment).  It still seems so foreign to me that this would be a financial conflict.  Wait, I guess the current medical system, where physicians are paid more if they do more procedures, leads to the conflicts that Mr. Jefferson was worrying about.  I wonder why Jefferson wasn't quoted during the recent health care reform debates?

Peter Orszag's NY Times column

VCU Surgical Department History

VCU Health Sciences page

1 comment:

  1. For an excellent discussion on the conflict between science and patients, see Sunday's front page New York Times article on a clinical trial for a new melanoma drug. In this piece, 2 cousins with melanoma entered the trial; one was assigned to receive the new drug and the other was assigned to standard therapy. See: