Managing Conflicts of Interest

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Policy helps physicians navigate interactions

The Board has approved an updated policy developed to help physicians navigate their interactions with industry and manage conflicts of interest that impact patient and public trust.

The Conflicts of Interest and Industry Relationships policy sets expectations in the context of clinical practice, continuing medical education/continuing professional development, consultation and advisory boards, and industry-sponsored research.

The policy maintains the essential elements of the consultation draft, including the requirements for transparency and proactive disclosure of conflicts of interest, and the management and resolution of conflicts in the patient’s best interest.

The policy gives greater prominence to content related to conflicts of interest set out under Ontario Regulation 114/94 (the General regulation) under The Medicine Act, 1991. This change was made in response to 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. A new provision expands these obligations by prohibiting physicians from actively directing patients to a specific supplier or facility (e.g., pharmacy) unless the patient requests it.  

The policy does not discourage appropriate interactions with industry

The 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).

The policy does not discourage appropriate interactions with industry, and states at the outset that interactions between physicians and industry may legitimately benefit physicians and patients by advancing medical knowledge, supporting professional development, and improving patient care. This is consistent with the policy’s goal of supporting reasonable and appropriate industry interactions while protecting the public from undue industry influence.

“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,” said Dr. Karen Saperson, Chair of the Policy Working Group.

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

Four Highlights of the Policy

In the best interests of patients, physicians must:

  1. Maintain clinical objectivity and professional independence when interacting with industry.
  2. Proactively disclose the details of the conflict to relevant parties where the conflict cannot be avoided and resolve any conflict in the patient’s best interests.
  3. Consider the potential influence of industry-supplied samples on their prescribing choices and use clinical evidence to determine the appropriate choice of a drug or device in alignment with the patient’s best interests.
  4. Comply with relevant standards set by accrediting bodies for Continuing Medical Education, national guidelines for research and best practice recommendations for authorship.