FEATURE
responsibilities and to
ensure that a patient’s
trust in his or her physician is maintained.
The research suggests that
when a gift or gesture is
bestowed, it imposes on
the recipient a sense of
indebtedness.
A recent study found that those patients who believed
that physicians accepted industry gifts were significantly
more likely to report low trust in their physician and
higher levels of health-care system distrust.
Dr. Gabel, who was
on the working group
that oversaw the draft
policy development,
noted that a growing body of empirical
evidence demonstrates
that patient trust and
clinical care can be
adversely affected by
these conflicts.
“One potential impact of our finding,” wrote the
researchers,“is that physicians should recognize how gift
relationships could negatively impact the doctor-patient
relationship regardless of whether they believe they are
influenced by these relationships.”
“Research demonstrates that accepting
gifts or inducements
from industry influences and likely undermines a physician’s
independent clinical judgment, even where the physician believes otherwise,” said Dr. Gabel.
The research suggests that when a gift or gesture is
bestowed, it imposes on the recipient a sense of indebtedness. “The obligation to directly reciprocate, whether
or not the recipient is conscious of it, tends to influence
behaviour,” states a University of Pennsylvania paper
published in the American Journal of Bio-ethics.
More recently, research has found that such conflicts,
even perceived conflicts, may undermine patient trust.
So whether or not a particular marketing activity
adversely influences a physician’s prescribing may be
completely irrelevant if there is an underlying negative
effect on trust given its important role in the doctorpatient relationship, wrote the researchers.
“Patients depend on us to make clinical decisions that
are squarely in their best interests,” said Dr. Gabel.
“It is understandable that trust would be jeopardized
should they believe that other factors – separate from
their well-being – could come into play as we determine
which drug or treatment they should be receiving,” he
said.
The draft policy – which is a consolidation of the
Conflict of Interest: Recruitment of Subjects for
Research Studies and MD Relations with Drug
Companies policies – also provides guidance on the
following topics: clinical practice, CME/CPD, consultation or advisory boards/investigators meetings; and
industry-sponsored research.
We look forward to receiving your feedback and urge
you to read the full draft on our website. It is easy to
provide feedback right on the consultation page.
Have your say
Please provide feedback on our draft policy that provides guidance for physicians
in managing their relationships with industry appropriately, by May 14, 2014.
More information can be found on the College website at www.cpso.on.ca under Policies and Publications>Consultations
Contact: [email protected]
Mailing address:
College of Physicians and Surgeons of Ontario, 80 College Street, Toronto, Ontario M5G 2E2
Attn: Relationships with Industry
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DIALOGUE • Issue 1, 2014