In the New England Journal of Medicine, Matthew McCoy and colleagues, including Ezekiel Emanuel, examine conflicts of interest arising from the presence of industry executives on the boards of patient-advocacy organizations. Previous research has raised concern that the presence of industry leaders on the boards of these non-profit organizations may lead to advocacy for questionable reforms that do not always benefit the organizations’ constituents. The authors analyzed tax records, annual reports, and websites of 104 of the largest U.S patient-advocacy organizations to understand how conflicts of interest exist, are minimized, and are disclosed. They found that, among these patient-advocacy organizations, at least 83% received financial support from drug, device, and biotechnology companies, and at least 39% have a current or former industry executive on the governing board. Furthermore, current disclosure practices and self-regulation efforts regarding conflicts of interest are limited, with only 12% of organizations having published policies in this regard. The authors conclude by calling for legislative change and improved organization reporting practices, noting that greater transparency would allow citizens and policymakers to more accurately assess conflicts of interest.