Managing financial and nonfinancial conflicts of interest in healthcare delivery. 2010

Aaron S Kesselheim, and William H Maisel
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA 02115, USA. akesselheim@partners.org

The issue of conflicts of interest held by physicians and other caregivers has drawn increased attention in recent years. In response, some commentators and institutions have proposed policies intended to protect patients' rights, including disclosure of relationships with for-profit companies. Conflicts of interest policies must balance the need for transparency and patient safety, but must also take into account the positive aspects of such relationships, including innovative product development. This article discusses various types of conflicts that can and do occur in healthcare delivery and potential policy options that may address these issues. The case history, device, physician, and patient described below do not represent actual people or events, but are intended to be emblematic of the challenges faced in the current medical marketplace.

UI MeSH Term Description Entries
D010819 Physician's Role The expected function of a member of the medical profession. Physicians' Role,Physician Role,Physician's Roles,Physicians Role,Physicians' Roles,Role, Physician's,Role, Physicians',Roles, Physician's,Roles, Physicians'
D010820 Physicians Individuals licensed to practice medicine. Physician
D003695 Delivery of Health Care The concept concerned with all aspects of providing and distributing health services to a patient population. Delivery of Dental Care,Health Care,Health Care Delivery,Health Care Systems,Community-Based Distribution,Contraceptive Distribution,Delivery of Healthcare,Dental Care Delivery,Distribution, Non-Clinical,Distribution, Nonclinical,Distributional Activities,Healthcare,Healthcare Delivery,Healthcare Systems,Non-Clinical Distribution,Nonclinical Distribution,Activities, Distributional,Activity, Distributional,Care, Health,Community Based Distribution,Community-Based Distributions,Contraceptive Distributions,Deliveries, Healthcare,Delivery, Dental Care,Delivery, Health Care,Delivery, Healthcare,Distribution, Community-Based,Distribution, Contraceptive,Distribution, Non Clinical,Distributional Activity,Distributions, Community-Based,Distributions, Contraceptive,Distributions, Non-Clinical,Distributions, Nonclinical,Health Care System,Healthcare Deliveries,Healthcare System,Non Clinical Distribution,Non-Clinical Distributions,Nonclinical Distributions,System, Health Care,System, Healthcare,Systems, Health Care,Systems, Healthcare
D004864 Equipment and Supplies Expendable and nonexpendable equipment, supplies, apparatus, and instruments that are used in diagnostic, surgical, therapeutic, scientific, and experimental procedures. Apparatus and Instruments,Devices,Medical Devices,Device, Medical,Devices, Medical,Equipment,Inventories,Medical Device,Supplies,Device,Instruments and Apparatus,Inventory,Supplies and Equipment
D004992 Ethics, Medical The principles of professional conduct concerning the rights and duties of the physician, relations with patients and fellow practitioners, as well as actions of the physician in patient care and interpersonal relations with patient families. Medical Ethics
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016134 Organizational Policy A course or method of action selected, usually by an organization, institution, university, society, etc., from among alternatives to guide and determine present and future decisions and positions on matters of public interest or social concern. It does not include internal policy relating to organization and administration within the corporate body, for which ORGANIZATION AND ADMINISTRATION is available. Institutional Policy,Institutional Policies,Organizational Policies,Policies, Institutional,Policies, Organizational,Policy, Institutional,Policy, Organizational
D016265 Conflict of Interest A situation in which an individual might benefit personally from official or professional actions. It includes a conflict between a person's private interests and official responsibilities in a position of trust. The term is not restricted to government officials. The concept refers both to actual conflict of interest and the appearance or perception of conflict. Interest Conflict,Interest Conflicts
D030881 Disclosure Revealing of information, by oral or written communication. Financial Disclosure,Information Disclosure,Disclosure, Financial,Disclosure, Information,Disclosures, Financial,Financial Disclosures

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