Conflicts of interest between physicians' commitment to patient care and the desire of pharmaceutical companies and their representatives to sell their products pose challenges to the principles of medical professionalism. These conflicts occur when physicians have motives or are in situations for which reasonable observers could conclude that the moral requirements of the physician's roles are or will be compromised. Although physician groups, the manufacturers, and the federal government have instituted self-regulation of marketing, research in the psychology and social science of gift receipt and giving indicates that current controls will not satisfactorily protect the interests of patients. More stringent regulation is necessary, including the elimination or modification of common practices related to small gifts, pharmaceutical samples, continuing medical education, funds for physician travel, speakers bureaus, ghostwriting, and consulting and research contracts. We propose a policy under which academic medical centers would take the lead in eliminating the conflicts of interest that still characterize the relationship between physicians and the health care industry.

ROFESSIONAL MEDICAL ASSOCIAtions (PMAs), bringing together physicians in the same specialty or subspecialty, make many distinctive contributions to advancing the quality of medical care. In the first instance, PMAs play a vital role in medical education. Their meetings, publications, journals, and continuing medical education (CME) courses inform members of new and established diagnostic and treatment procedures. The PMAs also issue detailed practice guidelines that set the standards for efficient and effective patient care. Moreover, PMAs define ethical norms for their members, promulgating codes of conduct for professional behavior. At the same time, PMAs pursue a public agenda. They advocate for the particular interests of their members, for patients, and for what they believe to be the best interests of society. [1][2][3]

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Rothman (April 27 issue) (1) contends that medical professionalism is losing the battle against capitalism. My colleagues and I at the American Academy of Ophthalmology agree that medicine should be practiced in the best interest of the patient, not of our pockets, but Rothman's sweeping accusations against medical specialties and the academy, which are offered as sacrificial lambs in his crusade, are unfounded.

Social thermoregulation theory posits that modern human relationships are pleisiomorphically organized around body temperature regulation. In two studies (N = 1755) designed to test the principles from this theory, we used supervised machine learning to identify social and non-social factors that relate to core body temperature. This data-driven analysis found that complex social integration (CSI), defined as the number of high-contact roles one engages in, is a critical predictor of core body temperature. We further used a cross-validation approach to show that colder climates relate to higher levels of CSI, which in turn relates to higher CBT (when climates get colder). These results suggest that despite modern affordances for regulating body temperature, people still rely on social warmth to buffer their bodies against the cold.

Health advocacy organizations (HAOs) are influential stakeholders in health policy. Although their advocacy tends to closely correspond with the pharmaceutical industry's marketing aims, the financial relationships between HAOs and the pharmaceutical industry have rarely been analyzed. We used Eli Lilly and Company's grant registry to examine its grant-giving policies. We also examined HAO Web sites to determine their grant-disclosure patterns. Only 25% of HAOs that received Lilly grants acknowledged Lilly's contributions on their Web sites, and only 10% acknowledged Lilly as a grant event sponsor. No HAO disclosed the exact amount of a Lilly grant. As highly trusted organizations, HAOs should disclose all corporate grants, including the purpose and the amount. Absent this disclosure, legislators, regulators, and the public cannot evaluate possible conflicts of interest or biases in HAO advocacy.