Room for Improvement

Janice Simmons, for HealthLeaders Media , August 18, 2010
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Even the best of intentions may fall short if policies impede or fail to facilitate the desired outcome.


Healthcare leaders routinely make important decisions, many life-or-death decisions, ultimately. But it is the policies and procedures that are constructed to carry out those decisions that have tremendous impact, and not always in harmony with the leaders’ intent. The HealthLeaders Media online news team regularly covers policy matters, especially in cases where the policy itself may be called into question for what it does or fails to do. Here are excerpts from some recent examples filed by Cheryl Clark, Elyas Bakhtiari, and Janice Simmons.

99% of teaching hospitals lack clinical care conflict-of-interest policies

 Teaching hospitals have been writing conflict-of-interest policies covering research and corporate relationships, but they also should set rules for disclosing physicians’ clinical conflicts that can bias patient care, according to an Association of American Medical Colleges report released June 30.
“Less than 1% [of teaching hospitals] have adopted policies that define and address conflict of interest in clinical care,” said AAMC Chief Health Officer Joanne M. Conroy, MD. “This report is the first step in providing guidance on how these institutions can develop policies.”

Asked for an example of what sorts of conflicts these policies should cover, Conroy answers:

“Let’s say you’re having a hip replacement, and the orthopedic surgeon you’re meeting with actually was the inventor of one of the most commonly implanted hips in the U.S. He probably needs to disclose that to you if that’s part of the discussion of what kind of hip you’re going to receive.”

She added, however, that there are other questions the policy should address. “Does he disclose how much he makes from royalties from that company over a period of time or for your individual procedure?” Likewise, she said, if the doctor had a part in the development of a drug or medical device from which he or she receives royalties or fees, that should be disclosed, too.

The AAMC report, In the Interest of Patients: Recommendations for Physician Financial Relationships and Clinical Decision Making, is the third in a series that AAMC task forces have produced regarding conflicts of interest in medical schools and teaching hospitals. It includes seven recommendations for medical institutions to address the issue.

Reported by Cheryl Clark on July 1.

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