As medical progress continues to develop and medical diagnostic and medical treatments cause higher costs ,there is an urgent need to comment new developements in medical basic research and in clinical point of view .As clinical decisions have to be fast and faster and economic pressure increases continously there is less and less room for jung doctors to observe the response of their treatment approaches in both conservative and surgical medicine.For this reason economy may become a very important (hidden) variable in treatment flow sheets. A new definition of „conflict of interest“ should be discussed by ethical committees.