Conflicts of Interest: Dealing with the Inevitable! Conflicts of - PDF document

Conflicts of Interest: Dealing with the Inevitable! Conflicts of Interest: Dealing with the Inevitable! Conflicts of interest are inherent in all human relationships. Charlotte Jefferies Horty, Springer & Mattern Be Sensitive to, Conflicts of interest are and Manage, inevitable on every “Conflict of Interest” Medical Staff! Situations! Personal interest that might impair or reasonably appear to impair Health care is a combination of independent, unbiased judgment in the discharge of an individual’s regulation and competition. responsibilities to patients, institution and/or profession. 1

Conflicts of Interest: Dealing with the Inevitable! Conflicts Are Inevitable • Close friends • Personally involved in care of patient COI can be • Reviewed case at prior level real or perceived. • Raised the concern • Employment relationship/contract with hospital? COI in dual role – professional and businessperson: In medicine, decision-making is often made in best interest of: • Physician payment arrangements • Self-referrals • physician • Physician ownerships • hospital • Promotional activities • third-party payor • Participation in industry-sponsored • government clinical trials • Exclusive contracts Conflicts Are Inevitable Types of COI • Family member • Situational COI • Partner • Direct or indirect financial relationship • Pervasive – disqualifying COI • Competitor • History of conflict 2

Conflicts of Interest: Dealing with the Inevitable! Basic Rules Adopt Conflict of First: DISCLOSURE Interest Policy Second: RECUSAL Managing conflicts of interest Policy Should is essential to: • Require disclosure • Be fair to the physician under review • Authorize Chair (or committee) to resolve • Protect integrity of the process dispute over conflict. • Protect person with COI • Allow individual with a COI to provide information. Assess the Situation: • What’s at root of conflict? Whenever possible COI • What are barriers preventing should be raised and resolution? resolved before meeting. • What are the best interests? • What are guiding principles? 3

Conflicts of Interest: Dealing with the Inevitable! Safeguards Additional Practical Tips  Committee Chair always has discretion to recuse member in particular situation Choosing to refrain from if the Chair determines that the participation is not a conflicted member’s presence would:  Inhibit the full and fair discussion of finding of actual conflict! the issue  Skew the recommendation or determination of the committee, or  Otherwise be unfair to the practitioner under review Minutes should reflect the Routine disclosure of potential individual with the COI left COI should be a basic inherent the meeting before ethical responsibility. discussion and did not vote. Additional Practical Tips No staff member has a RIGHT to demand recusal – within the discretion of leadership 4