Conflict of interest week 3 written assignment mha

Running Head: Health Care Conflict of 1

Health Care Conflict of Interest

Susan Hendrix

MHA 614: Policy Formation and Leadership in Health Organizations

January 23, 2012

Dr. Donna Williams



Conflict of interest can occur in any business which leads to misjudgment that can cause

harm to an organization. A conflict of interest in health care, can influence a health care provider

to alter his or her treatment of care of a patient, this conflict can be based on prior loyalties too

pharmaceutical companies, medical supply companies, and even insurance companies. Conflicts

of interest occurs within health care when providers self-interest along with personal interest

which interferes with professional judgment or actions.

Pozgar (2010) states “the potential for conflict of interest exists for individuals at all levels

within an organization. Disclosure of potential conflicts of interest should be made so that

appropriate action may be taken to ensure that such conflict does not inappropriately influence

important organization and health care decisions”. One widely known conflict of interest that

has existed between health care practice has been with the pharmaceutical companies. Over the

past several years more attention has been given to the issue of physician/pharmaceutical

relationships and conflict of interest.

The National Physicians Alliance reports “in 2007, there was approximately 1 drug rep for

every 7 doctors in the U.S., and it was estimated that the pharmaceutical industry spent close to

$30 billion in 2005 on marketing, the majority of the money spent on samples and detailing

physicians”. Amongst the detailing of physicians there exist the free lunches which are provided

to staff members, dinners for the physician and his family, tickets to sporting games, these free

gifts that is provided by the drug reps presents an ethical issue to the physician. By accepting

these free gifts the physician in turn will prescribe drugs to their patients, which in turns makes

the pharmaceutical company money, but it also rises the cost of health care.

In 2007, Eli Lilly and Company gave the National Alliance on Mental Illness $450,000

toward its campaign for the Mind of America, which if successful, could greatly expand the

market for Lilly's newest and most expensive psychiatric drug( Ruvinsky, J.). A contribution



such as this is normally not made public, there have been a large number of organizations that

did not disclose “industry contributions. The New York Times (2012) reports that “to head off

medical conflicts of interest, the Obama administration is poised to require drug companies to

disclose the payments they make to doctors for research, consulting, speaking, travel and

entertainment. Manufactures of prescription drugs and devices will have to report if they pay a

doctor to help develop, assess and promote new products – or if, for example, a pharmaceutical

sales agent delivers $25 worth of bagels and coffee to a doctors office for a meeting(Pear, R).

Self-referral and physician ownership of health care facilities also creates conflict of interest

this could be based on dual roles which consists of the role as professional and businessperson..

This dilemma is evident, first, in the growth of physician ownership of outpatient diagnostic or

treatment centers and specialty hospitals to which they refer patients and, second, in the increase

in expensive in-office ancillary equipment. Physicians' ownership interest in facilities to which

they refer patients constitute a conflict of interest. This interest has the potential to bias

physicians' primary interest in their patients welfare(National Institute of Health).

Some conflict of interest may harm patients who receive unnecessary services and may also

harm society, which is burdened by excess spending on these services. Concerns over such

practices prompted the passage of federal legislation and implementation of the “Stark laws”. In

general, federal law prohibits physicians from referring Medicare or Medicaid beneficiaries to

entities for “designated health services” if the physicians or their immediate family members

have ownership or investment interests in the entities or have compensation arrangements with

entities (42 USC 1395nn and 42 USC 1396b(s))(National Inst.Health).

Physicians and researchers must exercise judgment in complex situations that are fraught

with uncertainty. The public needs to trust that these judgments are not compromised by

physicians or researchers. Ties with industry are common in medicine. Many faculty members



faculty members receive research support from industry, and industry funds the majority of

biomedical research in the United States; many faculty members and community physicians

provide scientific, marketing, and other consulting services to companies; and serve on company

boards of directors or on industry speakers bureaus. Such conflicts of interest threatens the

integrity of scientific investigations, the objectivity of medical education, and the quality of

patient care. They may also jeopardize public trust in medicine(Lo, Mayfield).

To help eliminate these conflicts of interest it is important to have policies established along

with the creation of conflict of interest committees to evaluate and mange conflicts. Focus on

policy steps which would require physicians, researchers, and senior officials to disclose to their

facilities, institutions the financial relationships within the health industry. There further more

needs to exist more stringent laws by U.S. Congress that would require pharmaceutical, medical

device, along with biotechnology companies and foundations to publicly reports payments to

physicians, researchers, and health care institutions.

Conflict of interest can occur in any business which leads to misjudgment that can cause

harm to an organization. A conflict of interest in health care, can influence a health care provider

to alter his or her treatment of care of a patient, this conflict can be based on prior loyalties too

pharmaceutical companies, medical supply companies, and even insurance companies.


References

Lo, B., Mayfield, M.J., (2009) Conflict of interest in medical research, education.

DC: The National Academies Press.

National Institute of Health (2009) Conflict of Interest and Medical Practice. Retrieved

January 20, 2012, from http://www.ncbi.nlm.nih.gov/books/NBK22944.

National Physicians Alliance (2012) Conflict of Interest with Pharmaceutical Industry. Retrieved

January 21, 2012, from http://npalliance.org/integrity-trust-in-medicine/conflicts-of-interest-

with-pharmaceutical-industry

Pear, R., (2012, January 17) Fees To Doctors By Drug Makers To Be Disclosed:[National Desk]

New York Times (Late Edition (east Coast) ), p.A.1. Retrieved January 21, 2012, from

Banking Information Source. (Document ID: 256976051 )

Pozgar, G.D., (2010) Legal and ethical issues for health professional (2nd ed.

MA: Jones and Bartlett Publishers.

Ruvinsky, J., (2011, October ) Undisclosed Pharma Contributions. Standford Social Innovation

Review, 9(4), 8-9. Retrieved January 21, 2012,from ABI/INFORM Global.

(Document ID: 2561976051 ).

Conflict of interest week 3 written assignment mha

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