WCH CONNECTJanuary 28, 2019

Managing potential conflict of interest

  • January 28, 2019
  • BY Patricia North

The Legal Brief is a series featuring Patricia North, chief legal officer for Women’s College Hospital. Patricia has extensive expertise in the healthcare sector and handles all types of hospital legal and policy issues. Stay tuned to Connect for future Legal Brief articles on a variety of topics.

During the upcoming physician re-credentialing cycle starting in February, Women’s College Hospital (WCH) is adopting a new approach to managing potential conflict of interest situations.

The focus of this approach is on the disclosure and management of relationships or partnerships that physicians may have with other organizations or individuals which could give rise to a conflict of interest or the appearance of a conflict of interest. The goal is to support physicians who have such relationships and to provide consistent advice and strategies for avoiding conflicts and managing potential risks. 

A few years ago, the TAHSN (Toronto Academic Health Science Network) hospitals formed a working group on relationship management which resulted in the development of both a policy and a disclosure module which now forms part of the CMaRS software used by physicians to apply for re-credentialing for hospital privileges. A number of TAHSN hospitals have now implemented the CMaRS disclosure module, and others are committing to implement this process in upcoming years. WCH is now joining this process.

The good news for physicians is that the CMaRS system makes it fairly easy to report on these types of relationships. Physicians can choose which of their hospitals their relationships are relevant to, eliminating the need to reproduce the same information for each hospital they are credentialed at. In addition, the process is intended to align with the University of Toronto’s disclosure requirements, allowing for a streamlined process with our academic partner. There are seven main ‘buckets’ of potential relationships, these include: 

1. Consulting
2. Intellectual Property
3. Business with a Personal Associate
4. Non-Research Funding
5. External Appointments
6. Holdings
7. Other (That is any relationships not already disclosed that might impact, or be perceived to impact your impartiality or objectivity in fulfilling your role at the hospital.)

An initial high-level question is asked under each subject matter heading, followed by a series of more detailed questions where applicable.

Hospitals which have implemented the module report that approximately 20 per cent of physicians reported having one or more relationships, with the majority of relationships reported in the ‘consulting’ category, followed by ‘non-research funding’ and ‘external appointments’.

In certain situations, relationship management plans will be put in place to assist physicians with addressing potential areas of concern identified through the disclosure process. Additional information will follow over the next few months as the process is rolled out.

Apart from this approach, WCH has a separate general Conflict of Interest policy which pertains to all clinicians, staff, researchers and students.

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