Tools for Managing the High Ground: Putting Trust and Analytics into Medical Conflict of Interest

Managing medical conflicts of interest with accepted standards and practices is the direction we are headed in but the path is not well marked. "Physician Conflict Of Interest" may be defined as any possible compromising of a physician's professional judgment for the purpose of financial reward. It is also presumed to be a conflict if ownership is present, even if the judgment is not compromised and there is no financial gain in the process. In either case operating within acceptable boundaries with full disclosure offers the best opportunity for medical excellence and public trust.


In April 2009 the Institute of Medicine (IOM) completed its report on collaboration between industry and HCPs.  The IOM report stressed the need to prevent bias and mistrust which undermines the value of work being done by the medical community and the industry. The report focused specifically on financial conflicts of interest involving pharmaceutical, medical device, and biotechnology companies.


IOM’s conclusion states; “Society traditionally has placed great trust in physicians and researchers, grant­ing them the considerable leeway to regulate themselves. However, there is growing concern among lawmakers, government agencies, and the public that extensive con­flicts of interest in medicine require stronger measures. Responsible and reasonable conflict of interest policies and procedures will reduce the risk of bias and the loss of trust while avoiding undue burdens or harms and without damaging constructive collaborations with industry. Decisions about biomedical research, medical education, and patient care directly affect the public’s health. The public needs to be able to trust that physicians’ decisions are not inappropriately influenced by their financial rela­tionships with industry.”

While the committee recommended the implementation of policies and procedures to reduce the risk of conflicts, change has been gradual. Currently, much to the dismay of many, the wheels are in motion for the Physician Payments Sunshine Act (PPSA) to confront the controversy.  This corrective action may be a bitter pill to swallow in the coming months but in the long term, management of the process will disclose more than just the originally intended payments to HCPs. The release of payments made to the medical community is the high ground for the industry that can help recapture public trust. In addition the emerging data is revealing previously unknown new perspectives on industry spending patterns, priorities and budgets providing competitive information on contracted services.

In past weeks additional installments of manufacturer disclosure information were released for public consumption.  This latest release has again sparked media attention and increased concern about physicians, hospitals, ancillary health facilities and industry conflicts of interest. As information trickles out in advance of the PPSA deadline, shock and criticism are the story lines as reaction to the sums being paid for contracted services get reviewed. But also emerging from the scattered data sources is a new set of data offering the opportunity for competitive analytics on a segment of industry where investments are likely to exceed one billion dollars a year. 


Efforts to aggregate posted company payments to physicians have led to the creation of Physician Contracting Analysis (PCA); a database and analytics tool. Using the latest in business intelligence software along with skilled data management techniques, PCA has created new levels of analytics around the reported payment data. The new data and analytics capabilities have opened up unexpected amounts of information that savvy professionals can use for strategic and tactical advantage.


As PPSA continues to be unpopular to many, including providers, the industry should seize the opportunity to recapture the high ground on public trust by actively participating in PPSA and exploring the competitive environment that is HCP contracted services. A look at how the industry collaborates with the medical community cannot only have positive impact on the public; it can also be a good way to more effectively manage the business.

To read more about PCA go to www.nhhsHealthcare.com