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Conflicts of Interest: Dealing with the Inevitable!
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Conflicts of Interest: Dealing with the Inevitable!
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Be Sensitive to, and Manage, Conflict of Interest Situations! 1 - - PDF document
Be Sensitive to, and Manage, Conflict of Interest Situations! 1 - - PDF document
Conflicts of Interest: Dealing with the Inevitable! Conflicts of Interest: Dealing with the Inevitable! Charlotte Jefferies Horty, Springer & Mattern Be Sensitive to, and Manage, Conflict of Interest Situations! 1 Conflicts of
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Conflicts of Interest: Dealing with the Inevitable!
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Conflicts of interest are inevitable on every Medical Staff!
Personal interest that might impair
- r reasonably appear to impair
independent, unbiased judgment in the discharge of an individual’s responsibilities to patients, institution and/or profession.
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COI can be real or perceived.
In medicine, decision-making is
- ften made in best interest of:
- physician
- hospital
- third-party payor
- government
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Conflicts of Interest: Dealing with the Inevitable!
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Conflicts Are Inevitable
- Family member
- Partner
- Direct or indirect financial relationship
- Competitor
- History of conflict
Conflicts Are Inevitable
- Close friends
- Personally involved in care of patient
- Reviewed case at prior level
- Raised the concern
- Employment relationship/contract
with hospital?
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COI in dual role – professional and businessperson:
- Physician payment arrangements
- Self-referrals
- Physician ownerships
- Promotional activities
- Participation in industry-sponsored
clinical trials
- Exclusive contracts
- Situational COI
- Pervasive – disqualifying COI
Types of COI
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Basic Rules
First: DISCLOSURE Second: RECUSAL
Managing conflicts of interest is essential to:
- Be fair to the physician under review
- Protect integrity of the process
- Protect person with COI
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Assess the Situation:
- What’s at root of conflict?
- What are barriers preventing
resolution?
- What are the best interests?
- What are guiding principles?
Adopt Conflict of Interest Policy
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Policy Should
- Require disclosure
- Authorize Chair (or committee) to resolve
dispute over conflict.
- Allow individual with a COI to
provide information.
Whenever possible COI should be raised and resolved before meeting.
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Committee Chair always has discretion
to recuse member in particular situation if the Chair determines that the conflicted member’s presence would:
Inhibit the full and fair discussion of
the issue
Skew the recommendation or
determination of the committee, or
Otherwise be unfair to the practitioner
under review
Safeguards
Minutes should reflect the individual with the COI left the meeting before discussion and did not vote.
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Additional Practical Tips
No staff member has a RIGHT to demand recusal – within the discretion
- f leadership
Additional Practical Tips
Choosing to refrain from participation is not a finding of actual conflict!
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