Content area
Full Text
This policy paper investigates whether physician conflicts of interest have an effect on physicians' quality of care and whether implementation of conflict-of-interest policies will ameliorate any negative effects of divergent interests. Some government regulations are discussed in a policymaking perspective. We also suggest that healthcare organizations establish specific policies guarding against potential negative outcomes related to conflicts of interest. At the pinnacle of the conflict-of-interest debate resides the patient. One of the most important effects of disclosure is providing patients with the opportunity to make informed decisions regarding their healthcare. Research supports that conflicts of interest are inherent and oftentimes unavoidable in the healthcare setting.
KEY WORDS: Conflicts of interest; quality of care; transparency; perks; regulations; self-referral.
[This is the first part of a two-part article.]
Physician conflict of interest is a serious concern in the healthcare community. The literature documents negative evidence in relation to physician conflicts of interest including physician ownership of medical facilities,1 physician self-referral,2 receiving gifts from the industry,3 and industry-sponsored research.4 Many conclusions have been drawn showing correlations among financial incentives, physician prescribing patterns, treatment option decisions, and care recommendations.57 However, little attention has been paid to conflicts of interest and their direct effects on quality of care from a policymaking perspective, and the evidence is openly interpreted by the individual researchers.8
Research on this topic is limited as direct causation is difficult to prove. Using the policy analysis framework (Figure 1), we contend that physician conflict of interest in relation to quality of care may be effectively addressed by: 1) understanding and defining related problems; 2) identifying and analyzing alternative solutions; and 3) choosing best policy alternatives. The feedback loop reflects the function that helps resolve an issue that was inadequately addressed in different policy analysis stages.
Despite varying opinions as to the implications of conflicts of interest and physicians' choices, it would be advantageous to determine if these alternate interests affect the care that a patient would receive from a provider. Also, less is clear about the role of policymaking in the association of physician conflict of interest with quality of care in the literature. This research aimed to explore from a policy perspective whether physician conflicts of interest have an effect on physicians' quality of care...