Navigating Conflicts of Interest in Healthcare Management

Categories: Conflict Health Personal Interests

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A conflict of interest is defined as a conflict between the professional or personal interests and needs of a health care provider and his or her professional responsibilities toward a patient or other consumer (financial gain based on a particular outcome or use of one drug rather than another). Partners Healthcare states that “A conflict of interest is a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest.” Our textbook defines a conflict of interest as “when someone has multiple obligations that demand loyalty, and decisions based on these loyalties are different or in conflict” (Page 180)

Partners Healthcare has an array of examples of conflicts of interest.

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Some being:

“Receiving consulting fees from a company while performing clinical research on the company’s technology.”
“Accepting a gift from a vendor” and
“Participating in institutional purchasing decisions about products made by a company in which you hold stock.” -- This presents a conflict that is always unacceptable.

In order to minimize conflicts of interest in managed care the dual interests present in the relationships among MCOs, members and physicians has to first be acknowledged.

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This awareness permits avoiding or minimizing them. An ombudsman or consumer relations specialist can assist members can decrease conflicts of interest by assisting members and dealing with their concerns. (Page 181)

The role of a manager is expected to have expectations: to focus on the welfare of those receiving care; maintain professional competence; maintain professional posture, holding paramount the interests of facility and residents; and meet the responsibilities to the public, profession, and colleagues.

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Managers must be aware and take steps to prevent or minimize potential or actual conflicts of interest. This could be through developing and maintaining high ethical standards in the profession, including searching out those who knowingly engage in conflicts of interest and educating those ignorant of them.