Truth or Consequences—Academic Physicians’ Perspective in the Management of Commercially-influenced Conflicts of Interest

Since the 1990s, academic physicians have been subjected to increased requirements for disclosure in their roles as educators and researchers and for conflict of interest (COI) resolution in their financial relationships with pharmaceutical, medical device, and biotech companies, collectively referred to as industry. The requirements are the result of the convergence of federal regulations, accreditation guidelines, professional and industry codes of ethics and conduct, and institutional policies. The disclosure and COI resolution requirements are managed and resolved by a review of forms and compliance with relevant guidance documents and policies. In the context of this environmental oversight, the purpose of the qualitative study was to explore physicians’ perspectives of how they manage and resolve conflicts of interest in their academic roles of teaching, research, and patient care. Minimal evidence-based research exists in the literature from the physician’s viewpoint. The grounded theory study examined the research question by using an issue-contingent, ethical decision-making theoretical framework from the management literature. The data were collected using a general interview guide that consisted of three sections – general questions regarding purpose and demographics, discussion of three case scenarios (teaching, research, and clinical practice), and finally, general concluding questions to assess the environment that is indicative of the context of the study. The theory emerged from the interview data as a refined theory representing a four-step ethical decision-making process with emphasis on the characteristics of physicians as moral agents. The study’s findings further indicated that bias is a significant concern. The study identified reasons physicians enter into financial relationships with industry, the risks and benefits associated with those relationships, methods for avoiding bias, and the need for healthy academic-industry collaborative research

Truth or Consequences—Academic Physicians’ Perspective in the Management of Commercially-influenced Conflicts of Interest

Since the 1990s, academic physicians have been subjected to increased requirements for disclosure in their roles as educators and researchers and for conflict of interest (COI) resolution in their financial relationships with pharmaceutical, medical device, and biotech companies, collectively referred to as industry. The requirements are the result of the convergence of federal regulations, accreditation guidelines, professional and industry codes of ethics and conduct, and institutional policies. The disclosure and COI resolution requirements are managed and resolved by a review of forms and compliance with relevant guidance documents and policies. In the context of this environmental oversight, the purpose of the qualitative study was to explore physicians’ perspectives of how they manage and resolve conflicts of interest in their academic roles of teaching, research, and patient care. Minimal evidence-based research exists in the literature from the physician’s viewpoint. The grounded theory study examined the research question by using an issue-contingent, ethical decision-making theoretical framework from the management literature. The data were collected using a general interview guide that consisted of three sections – general questions regarding purpose and demographics, discussion of three case scenarios (teaching, research, and clinical practice), and finally, general concluding questions to assess the environment that is indicative of the context of the study. The theory emerged from the interview data as a refined theory representing a four-step ethical decision-making process with emphasis on the characteristics of physicians as moral agents. The study’s findings further indicated that bias is a significant concern. The study identified reasons physicians enter into financial relationships with industry, the risks and benefits associated with those relationships, methods for avoiding bias, and the need for healthy academic-industry collaborative research