Navigating Interactions with Industry

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Draft policy now out for consultation

Council released a draft policy for consultation, which was developed to help physicians navigate their interactions with industry and manage conflicts of interest that impact patient and public trust.

The draft policy updates expectations in the Physicians’ Relationships with Industry: Practice, Education and Research policy approved in 2014, and has been retitled, Conflicts of Interest and Industry Relationships.

The structure and scope from the current policy are largely retained with expectations set in the context of clinical practice, continuing medical education/continuing professional development, consultation and advisory boards, and industry-sponsored research.

The draft policy includes content related to conflicts of interest that are set out under Ontario Regulation 114/94 (the General regulation) under the Medicine Act, 1991, in response to preliminary consultation feedback indicating most physicians were unaware of the General regulation’s content and would like guidance in the situations it describes, such as referrals or renting premises where the physician may receive a benefit.

In fact, the proposed policy, in alignment with CPSO’s right-touch regulation approach, significantly streamlines policy expectations by referring to established standards where they exist (including the National standard for support of CPD activities, the Tri-Council Policy Statement on Ethical Conduct for Research Involving Humans (TCPS-2), and the International Committee of Medical Journal Editors’(ICMJE) recommendations on authorship).

Industry has a valuable and legitimate role to play in the practise of medicine, and the draft policy recognizes that role, said Dr. Karen Saperson, a member of CPSO’s Policy Working Group.

“In fact, the draft does not discourage appropriate interactions with industry, and states at the outset that relations between physicians and industry have the potential to benefit both physicians and patients by advancing medical knowledge and improving patient care,” said Dr. Saperson, a professor of psychiatry at McMaster.

“The interests and responsibilities of industry, however, are not always aligned with the professional and legal obligations of physicians. As a result, physicians may find themselves facing ethical dilemmas or potential conflicts of interest stemming from their relationships with industry,” she added.

Adherence to the expectations will help physicians manage their interactions with industry appropriately, said Dr. Saperson.

We invite physicians to participate in the consultation. Your feedback on our policies, regulations, by-laws and other initiatives is essential to informing our work.

5 Things to Know about the Proposed Policy

Physicians must:

  1. Maintain their clinical objectivity and professional independence when interacting with industry.
  2. Fulfil their fiduciary duties to patients by acting in good faith and in the patient’s best interest when resolving conflicts of interest.
  3. Disclose conflicts of interest when ordering diagnostic or therapeutic services to be performed at a facility where they or a family member has a proprietary interest, and be clear that patients can choose to receive those services elsewhere.
  4. Consider the potential influence of industry-supplied samples on their prescribing choices and use clinical evidence to determine the appropriate choice of drug or device in alignment with the patient’s best interests.
  5. Comply with relevant standards set by accrediting bodies for CME, national guidelines for research and best practice recommendations for authorship.