When Dr. Bruce Psaty published an article the use of beta-blockers to treat high blood pressure, he and his family were invited to a first-class resort, where he presented the results at a sponsored conference. He agreed to help develop a set of slides on beta-blockers, and soon found himself suggesting that the drug company's studies be featured, in part because he felt "a kind of social duty to reciprocate both the kindness and the investment made by the sponsor in the slide set."

Psaty’s story illustrates the problem of conflicts of interest in the medical world. Subtle conflicts of interest often color decision making, even though most people -- especially doctors -- think they are immune.

Several states including Massachusetts, Minnesota and Vermont are tightening restrictions on gifts to doctors in the hopes of preventing such conflicts. But while such laws may curb some financial conflicts, a bigger challenge will be addressing the influence drugmakers have over company-funded research geared towards supporting the safety and effectiveness of the drugs they make.