at age 82, has embarked on another career. The esteemed pediatric surgeon and former U.S. Surgeon General who achieved great acclaim for his positions on cigarette smoking, nutrition, environmental controls, immunization, and disease prevention is now a businessman. In 1998, with the help of several investors, he started DrKoop.com, a web site whose stated goal is "to be the most trusted and complete source of consumer healthcare information." As chairman of DrKoop.com and a major stockholder, his financial holdings in the company are estimated to be worth more than $47 million.
Despite Dr. Koop's impeccable credentials, he and DrKoop.com have recently come under heavy criticism from the lay press, the AMA, and numerous other consumer advocacy groups. Those groups accuse Dr. Koop of failing to disclose that he and his company receive a commission on products and services advertised on the web site. An editorial in the New York Times opined that "DrKoop.com has blurred the line between its objective information and its advertising or promotional content and that his ties to business have not been properly disclosed."
An example of Dr. Koop's conflict of interest is DrKoop.com's Community Partner Program in which the following icon appears: "Sponsor-Find a healthcare provider near you." If you click on the icon, a (very) small list of integrated healthcare systems appears. In my geographic area (New York City), none of the recognized experts and none of the highly regarded healthcare facilities are listed. In the second paragraph, it is casually mentioned that "member organizations pay a fee to participate." Obviously, this is not a partnership, it is an advertisement and should be clearly labeled as one.
Dr. Koop said he did not go into DrKoop.com to make money but "to change the way that medicine is practiced, to bring important information to the patients faster and get them more involved in decisions about their health." If we believe him, then there is no conflict. Moreover, my cursory browsing of the web site would suggest that the information contained therein is a reasonable start toward that goal, though it still has a long way to go. Furthermore, although he doesn't oversee the day-to-day operation of the web site, Dr. Koop has publicly taken responsibility for its content. If Dr. Koop achieves this and makes a lot of money himself, all the more power to him. But it makes us wonder.
Is it a conflict of interest when a world-renowned expert lectures on behalf of a commercial interest from which he receives a fee? Is it a conflict of interest when a healthcare advocacy group offers a list of qualified experts to prospective patients when the only qualification is board certification and payment of a listing fee? Is it a conflict of interest when a urologic or gynecologic organization offers a list of