Regardless of how society organizes medical care, it cannot preclude all conflicts of interest; and third parties have limited ability to oversee conflicts of interest because physicians need some discretion to perform their work. Moreover, regulation imposes costs. Controls and bureaucratic rules can demoralize professionals and interfere with their performing well. Whatever institutions and rules society uses to cope with conflicts of interest will be more effective if physicians not only respect them but if they are also guided by an ethos of public service, fidelity to patients, and commitment to knowledge and excellence. Here, professionalism can play an important role. This chapter explores its potential, limits, and relation to public policy, focusing on the United States.
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