Talking to your doctor about conflicts of interest

The Wall Street Journal Health blog pointed to an interesting article this morning in the Washington Post about potential physician conflict of interests and the difficulty patients have in asking their physicians about them. Patients don't want to ask questions that might alienate their physicians, but many express interest in knowing just how much influence pharmaceutical companies may have on their physician. There are some mechanisms for finding out this information on your own, such as physician and practice profiles online, especially if your physicians works for an academic medical center. And there is now proposed legislation to create greater transparency by disclosing all pharmaceutical company payments of more than $100. This transparency will equip patients to ask their physician more about their prescribing habits.

Of course, being able to find this information yourself is good, but it doesn't replace the real need for conversation between physicians and patients. Patients need to be able to express their concerns about potential physician conflicts of interest. Physicians need to know that their patients have concerns and perhaps help the patients gain insight into the physician's prescribing thought process. But the question is how to start these conversations between physicians and patients. Ideas?