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Conflict of Interest
Pre-Health Professional Development (HLTH 3300)
The University of Texas at Dallas
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Conflict of Interest ● Definition: a set of circumstances (different facilities, equipment, patient related) that creates different kinds of risks that professional judgment or actions regarding primary work will be unduly influenced by a secondary interest (something outside of the realm). ● This has been a huge problem for decades and has gotten worse over time. ○ Example: pharmaceutical companies and doctors ■ Pharmaceuticals now go directly to patient through ads and the patient will say “I think I need this”; not a lot of pharmaceuticals send reps to docs and educate them; instead they go and make an offer, “we will give you a prescription commission for each one filled.”; they then send a monthly check for prescriptions and can track how many of their prescriptions have been filled. ● There is a big risk for the patient - doc may also not give an effective drug or might give a more expensive one. ● 94% of doctors nationwide have the above relationship with pharmaceuticals, equipment, or health care industry. ● Some docs will give free samples. ● Very visible if the doctor is pushing you to get the medication. ● Creates trust issues between the patient and the doc. ● Investigative reporters have looked into this. Sunshine Payment Act in 2010 : required reporting of any type of relationship that could have a conflict of interest risk to patients; extends to pharmaceuticals, equipment, continuing education (as a reward), trips, new equipment for your hobbies, expensive dinners, expensive stuff that’s more than $100. ● Pharmaceuticals and durable medical equipment companies ● Required reporting: US is a central healthcare system so the reporting goes to MEDICARE program (reported annually) ○ Get form from medicare ○ If you have any part of ownership ○ Information is publically viewable on medicare website ○ Helps patients to figure out who they want to go see ● The following are required to report: M.D, D.O, Podiatrists, Optometrists, Chiropractors, and Dentists (PAs and MPs aren’t included). ● Required reporting by industry: pharmaceuticals, DME (durable medical equipment), and disposables. ● If the company says they’ve been giving gifts, but the doctor hasn’t said so, the doc will get a 10K fee per omission. ● Teaching hospitals also have to report any transfer of value: ○ Specifically for DME; ex. SONY goes to a hospital and says we’ll donate this gadget to you, which makes the doctors think that that’s the best one to perform on and will influence future facilities buying that kind of equipment ● Investment interests held by families also have to be reported by the health professional. ○ Only the professional is fined, not the family member. ● Professionals can lose their licenses and even get jail time. Continuing Education Conferences:
● The 3 industries will approach teachers to present new drugs (they will literally get a script for them). ○ Can be bad for you as a teacher because you don’t know the harmful effects ○ Thus you need to be skeptical! ● Now if you’re a presenter, you’re required to sign a form that says I’m not paid by any company or outside entity. ○ But guess what 65% of presenters will sign it but in reality they are lying (this is the % discovered, so there’s bound to be more). ● Frequency of getting a mammography is decided by an expert panel appointed by the CDC {65% of them are found later to have a conflict of interest}. ● “We’re both practitioners and patients”. Professional Journals ● At the end of an article they’ll give authors a form ○ “Financial support for this study was provided in full by ____” ■ Pushing for data to support us and also to slander other companies ■ Authors are getting paid by companies, NOT by publishers ■ Because of investigative reporting we now have a patient trust issue Conflict of Commitment ● Definition: When a scenario where there is a relationship which deters the doctor from giving all of their attention, skills, etc. to do responsibilities: ○ Example, the physical therapist works in rehab but also works with a home health company; she uses all of her time at the rehab to call and make appointments for home health. ○ Using company resources for another job.
Conflict of Interest
Course: Pre-Health Professional Development (HLTH 3300)
University: The University of Texas at Dallas
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