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Addressing Conflict of Interest in Healthcare

In 2018, I moderated this #HealthXPH tweet chat, Conflict of Interest in Healthcare. Intriguingly in the last paragraph, I said it was inspired by recent events. Well, that is the case again now (though I cannot remember what happened in 2018!).

What is conflict of interest? Nilda Fink quotes the Thompson definition in her publication, Conflicts of Interest and an Approach to Managing Them:

According to the Thompson definition, COI “is a set of conditions in which professional judgment concerning a primary interest tends to be unduly influenced by a secondary interest.” It can also be defined as a situation where a judgment or action that should be determined by a primary value established for professional or ethical reasons (protection of research subjects, production of safe knowledge, adequate assistance to the patient), may be influenced or appear skewed to obtain a secondary benefit.

Fink N. E. (2020). Conflicts of Interest and An Approach to Managing Them. EJIFCC31(4), 292–301.

In the same article, Fink lists types of secondary interests:

  1. Direct sponsored: payment for conferences, article writing, patient registrations for clinical studies, research of a product
  2. Indirect sponsored: gifts, travel, meals
  3. Laboral and academic development: prestige, academic acknowledgement or promotion
  4. Others: physician in charge of patients is also the researcher, and/or administrator of health resources, and/or consultant for marketing strategies

I’m reusing the 2018 #HealthXPH tweet chat questions. Join us on X later, 27 April 2024 9 pm Manila time.

T1 Give examples of conflict of interest in healthcare and its possible consequences.

T2 Should doctors voluntarily disclose conflicts of interest to their patients?

T3 How can doctors manage conflict of interest? What can patients do about conflict of interest?

I’ve been seeing many patients tweeting about losing trust in their physicians because of the recent pharmaceutical company scandal. Thompson et al (2021) reviewed the literature on patient perspectives on conflicts of interest. Some of their interesting findings below:

  1. In survey studies, 55-70% of participants are aware that doctors have financial interests with drug companies.
  2. Level of acceptance of such financial interests varied according to the type of interest, with 82% finding nonfinancial relationships with industry acceptable.
  3. Physicians with conflicts of interest were perceived to be top experts in their fields (72-74%) with only 8-11% considering them untrustworthy.
  4. More than half of participants felt the dollar amount involved in a physician-industrt relationship how that relationship will be perceived and that they would want to know the extent of the financial conflict of interest.

Certainly, there is much to discuss. See you later!

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