Subscription science: how crowdfunding has become a conflict of interest

Conflicts of interest are an ongoing threat to medical practice. Studies have shown that doctors’ treatment decisions can be directly swayed by industry payments.1 Pharmaceutical and medical device companies also assert indirect influence through the funding of thought leaders and guideline authors.23 Governments and professional bodies have attempted to reign in the impact of conflicts of interest in recent decades. Most medical journals now require standardised conflict of interest declarations.4 The US Physician Payments Sunshine Act requires manufacturers of drugs and devices to publicly report payments to physicians.5 These efforts have curtailed the overall number of US physicians receiving payments from industry, although large payments of more than $50 000 (£39 644; €45 560) might have increased.6 Financial relationships, even substantial ones, are not always nefarious. But patients, doctors, and regulators are right to be wary of the power of the purse.Crowdfunding has become another potent but overlooked source of…
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