跳至主要内容

Physicians and Conflicts of Interest

Read full paper at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=48943#.VJjZTcCAM4

In medical practice, the most commonly observed conflicts of interest are the ones existing in the relations between professionals and industries linked to health or between the former and health services. These relations are no longer a partnership in search of the best to be offered to patients and tend to take up a commercial role, in a seduction game where, each one, in their own manner, seeks benefits. The purpose of this study is to analyze the existence of these conflicts of interest, in an exploratory and qualitative study, with physician focal groups. The results were grouped in two categories: benefits received by physicians and the justifications provided by them for the establishment of these partnerships. The most common benefits are: percentages over orthoses and prosthetics received by the industry; discounts and credits on rent or condominium fees for exam indications and procedures; rewards offered by the pharmaceutical industry for the indication of their products. Physicians have pointed out as main determinants for ethical missteps that involve conflicts of interest, the character and family formation as well as the lack of denunciations. The fact that efficient and widespread laws for resolution of conflicts of interest do not exist makes it necessary to recognize their existence with mechanisms of management and transparency, perhaps as the only way to avoid negative interference in physician behavior.
Cite this paper
Pimentel, D. , Vieira, M. , Neves, J. , Costa-Neto, M. and Oliveira, L. (2014) Physicians and Conflicts of Interest. International Journal of Clinical Medicine, 5, 956-965. doi: 10.4236/ijcm.2014.516128. 
 

[1] Camilleri, M. and Cortese, D.A. (2007) Managing Conflict of Interest in Clinical Practice. Mayo Clinic Proceedings, 82, 607-614.
http://dx.doi.org/10.4065/82.5.607
[2] Tattersall, M.H.N. and Kerridge, L.H. (2006) Doctors Behaving Badly? The Medical Journal of Australia, 185, 299-300.
[3] Stepke. F.L. (2011) La psiquiatría actual y los conflictos de interés. VII Congreso Virtual de Psiquiatría: Interpsiquis 2006.
http://www.psiquiatria.com/articulos/psicosis/25548/?++interactive
[4] Manthous, C.A. (2009) On the Healthcare Question. The American Journal of Bioethics, 9, 1-3.
http://dx.doi.org/10.1080/15265160903439438
[5] Kitsis, E.A. (2011) Physicians and the Pharmaceutical Industry: Working Together on Conflict of Interest. The American Journal of Bioethics, 11, 51-52.
http://dx.doi.org/10.1080/15265161.2010.535600
[6] Dias, C.A. (2000) Grupo Focal: Técnica de coleta de dados em pesquisas qualitativas. Informação Sociedade, 10, 1-12.
[7] Suanno, M.V.R. (2002) Auto-avaliação institucional: Princípios e metodologia do Grupo focal. In: Bello, J.L.P., Ed., Pedagogia em foco, Rio de Janeiro.
http://www.pedagogiaemfoco.pro.br/avinst01.htm
[8] Minayo, M.C. (2006) O desafio do conhecimento. Pesquisa qualitativa em saúde. Hucitec/Abrasco, São Paulo.
[9] Bardin, L. (2004) Análise de Conteúdo. Edições 70, Lisboa.
[10] Steven, Z. and Glickel, M.D. (2009) The Ethics of Espedieny. The Journal of Hand Surgery, 34, 799-807.
http://dx.doi.org/10.1016/j.jhsa.2009.03.012
[11] Armstrong, D. (2005) Lucrative Operation: How Some Doctors Turn $79 Profit from a $30 Test Physicians Groups Add Markup to Work Done by Others, Despite Ethics Concerns Administrative Costs Cited. The Wall Street Journal, 30, A1-A8.
[12] Pimentel, D. (2012) Consultas curtas, excesso de exames, maior rentabilidade. Revista Somese, 127, 14.
[13] Tonelli, M.R. (2007) Conflict of Interest in Clinical Practice. CHEST, 132, 664-670.
http://dx.doi.org/10.1378/chest.07-0315
[14] Bove, A.A. (2009) President’s Page: Who Owns What or Whom? Journal of the American College of Cardiology, 54, 1814-1815.
http://dx.doi.org/10.1016/j.jacc.2009.10.003
[15] Massud, M. (2010) Conflito de interesses entre os médicos e a indústria farmacêutica. Revista Bioética, 18, 75-91.
[16] Guemundsson, S. (2005) Doctors and Drug Companies: The Beauty and the Beast? Acta Ophthalmologica Scandinavica, 83, 407-408.
http://dx.doi.org/10.1111/j.1600-0420.2005.00524.x
[17] Campbell, E.G., Gruen, R.L., Mountford, J., Miller, L.G., Cleary, P.D. and Blumenthal, D. (2007) A National Survey of Physician-Industry Relationships. The New England Journal of Medicine, 356, 1742-1750.
http://dx.doi.org/10.1056/NEJMsa064508
[18] Miller, J.D. (2006) Conflict-of-Interest Spurs New Rules, Not Consensus. Journal of the National Cancer Institute, 98, 1678-1679.
http://dx.doi.org/10.1093/jnci/djj508
[19] Marco, C.A., Moskop, J.C., Solomon, R.C., Geiderman, J.M. and Larkin, G.L. (2006) Gifts to Physician from the Pharmaceutical Industry: An Ethical Analysis. Annals of Emergency Medicine, 48, 513-521.
http://dx.doi.org/10.1016/j.annemergmed.2005.12.013
[20] Katz, D., Caplan, A.L. and Merz, J.F. (2010) All Gifts Large and Small: Toward an Understanding of the Ethics of Pharmaceutical Industry Gift-Giving. The American Journal of Bioethics, 10, 11-17.
http://dx.doi.org/10.1080/15265161.2010.519226
[21] Lambert, L.A., Jenny-Avital, E.R. and Blumenthal, D. (2005) Doctors and Drug Companies. The New England Journal of Medicine, 352, 733-734.
http://dx.doi.org/10.1056/NEJM200502173520722
[22] Jost, T.S. (2010) Oversight of Marketing Relationships between Physicians and the Drug and Device Industry: A Comparative Study. American Journal of Law of Medicine, 36, 326-342.
[23] Duvall, D.G. (2006) Conflict of Interest or Ideological Divide: The Need for Ongoing Collaboration between Physicians and Industry. Current Medical Research and Opinion, 22, 1807-1812.
http://dx.doi.org/10.1185/030079906X120977
[24] Aasland, O.G. and Forde, R. (2004) Legers holdninger og praksis i forhold til legemiddelindustrien. Tidsskrift Nor Laegeforen, 124, 2603-2606.
[25] Rotondo, M.T. (2006) Relaciones profe-sionales: Conflictos de intereses. Revista Médica del Uruguay, 22, 88-99.
[26] Grande, D. (2009) Limiting the Influence of Pharmaceutical Industry Gifts on Physicians: Self-Regulation or Government Intervention? Journal of General Internal Medicine, 25, 79-83.
http://dx.doi.org/10.1007/s11606-009-1016-7
[27] Alpert, J.S. (2005) Doctors and the Drug Industry: How Can We Handle Potential Conflicts of Interest? The American Journal of Medicine, 118, 99-100.
http://dx.doi.org/10.1016/j.amjmed.2004.12.003
[28] Pimentel, D. (2012) Conselho Federal de Medicina se rende à indústria. Revista Somese, 126, 32.
[29] Steinbrook, R. (2011) Industry Payments to Physicians: Comment on “Financial Payment by Orthopedic Device Makers to Orthopedic Surgeons”. Archives Internal Medicine, 171, 1765-1766.
http://dx.doi.org/10.1001/archinternmed.2011.439
[30] Hockenberry, J.M., Weigel, P., Auerbach, A. and Cram, P. (2011) Financial Payments by Orthopedic Device Makers to Orthopedic Surgeons. Archives of Internal Medicine, 171, 1759-1765.
http://dx.doi.org/10.1001/archinternmed.2011.454
[31] Taylor, M. (2006) Are Hospitals Next in Line? Government Investigators Probing Relationships between Physicians, Device Makers May Soon Train Sights on Hospitals. Modern Healthcare, 36, 24-26.
[32] White, A.P., Vaccaro, A.R. and Zdeblick, T. (2007) Counterpoint: Physician-Industry Relationships Can Be Ethically Established, and Conflicts of Interest Can Be Ethically Managed. Spine, 32, S53-S57.
http://dx.doi.org/10.1097/BRS.0b013e318053d54f
[33] Kassirer, J.P. (2007) Commercialism and Medicine: An Overview. Cambridge Quarterly of Healthcare Ethics, 16, 377-386.
http://dx.doi.org/10.1017/S0963180107070478
[34] Gunderman, R.B. and Hubbard, M.A. (2005) The Wages of Healing: Ethical Issues in the Compensation of Physicians. Medical Science Monitor, 11, 5-10.
[35] Czupryniak, L. and Loba, J. (2004) Route of Corruption in Poland’s Health-Care System. The Lancet, 364, 1856.
http://dx.doi.org/10.1016/S0140-6736(04)17436-9
[36] Pisano, E., Golden, N. and Schweitzer, L. (2014) Conflict of Interest Policies for Academic Health System Leaders Who Work with Outside Corporations. JAMA, 311, 1111-1112.
http://dx.doi.org/10.1001/jama.2014.788
[37] Nagral, J. and Roy, N. (2010) The Medical Council of India Guidelines on Industry-Physician Relationship: Breaking the Conspiracy of Silence. The National Medical Journal of India, 23, 69-71.                 eww141223lx

标签：

评论

发表评论

此博客中的热门博文