Yes, some relationships between physicians and medical device companies, pharmaceutical companies, and other businesses are legitimate and valuable and serve a public good. For the most part those sorts of relationships can be identified, defended and exempted from CCOI action.
Other CCOI practices are obviously wrong and should have been banned years ago. It shouldn't take an IOM recommendation to ban ghostwriting, and yet one-third of medical schools still allow it. Ghostwriting is either plagiarism, bribery, or both.
Accepting money or other compensation to shill for medical research that someone else did is worse than plagiarism because physicians are cashing in on their profession's hard-earned credibility and public trust to hawk a product. The actions of a few physicians who violate this public trust harm the reputations of the vast majority of physicians who do not.
Heather Pierce, senior director, science policy for the Association of American Medical Colleges, said in an email exchange with me that national transparency initiatives such as the Physician Payment Sunshine Act are spurring dialogue in medical colleges about the value of more-stringent CCOI policies.
This is encouraging. It is also unfortunate that medical schools may be motivated by fear of disclosure and public embarrassment to adopt common-sense CCOI standards and not because it's the right thing to do.
In any event, they should hurry up and do it.