Behavioral Science & Ethics USMLE Step 1 Practice Question
A 52-year-old cardiologist sees an average of 15 patients daily with hypertension. Over the past year, she has prescribed antihypertensive medications from Pharmacos Inc. in 60% of her hypertensive patients, compared to 35% five years ago before accepting a consulting contract. The contract pays $50,000 annually for attending 12 monthly meetings to provide feedback on the company's drug development pipeline. She has disclosed this relationship in her institutional conflict-of-interest form and continues meeting all continuing medical education requirements. Her prescribing pattern for competing antihypertensives from other manufacturers has proportionally decreased. Pharmacologically, all agents are similarly effective for her patient population. Which of the following best describes the primary ethical concern with this arrangement?
Answer choices
- AViolation of the Sunshine Act because the consulting contract was not publicly reported
- BBreach of fiduciary duty requiring the physician to prioritize patient autonomy by refusing all industry relationships
- CAn unconscious financial incentive that may compromise the physician's medical judgment despite disclosure and compliance with regulationsCorrect answer
- DIllegal inducement under federal anti-kickback statutes prohibiting payments for prescribing referrals
- EFailure to obtain informed consent from patients regarding the potential bias in medication selection
- FViolation of antitrust law due to unfair competitive advantage gained through the consulting relationship
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