How To Spot Conflict of Interest in Healthcare

Conflict of interest in healthcare has been a problem for decades. Conflict of interest (COI) is when a prescriber’s judgment is influenced by personal or financial gain rather than prioritizing the patient’s care and outcomes. The biased decisions of medical professionals because of financial or personal interests often misguide patients to take unsafe and inappropriate treatments or expensive medications that they might not actually need.  

This does not mean every provider with financial ties to pharmaceutical companies or diagnostic facilities can’t be trusted. However, if patients recognize these conflicts, they can make informed decisions about their health and opt for appropriate medical treatment. 

This article aims to educate patients about conflict of interest in healthcare, its various forms, how to spot signs of conflicts, and what steps you can take to ensure your health remains the priority. 

What Is Conflict of Interest?

When a prescriber’s interest (personal or financial benefits) interferes with their professional responsibilities, and there is a chance that medical professionals will prioritize these interests above patient care and health, this situation is described as a “conflict of interest.”

To identify a conflict of interest in a prescriber’s recommendation, it is important for you to first learn about its various forms. Conflict of interest in healthcare can take many forms, which include: 

1. Direct Financial Interest or Financial Incentives

The direct financial interest may include pharmaceutical or medical device companies and dispensaries that may send payments to healthcare professionals to promote their new drugs or medical devices. 

2. Ownership Interests

In ownership interest, when healthcare providers own or manage treatment facilities, they refer patients to those facilities for financial gain. 

3. Indirect Financial Interests

In indirect financial interests, the prescriber’s close relationships, such as friends, family members, or associates, gain benefits when they promote or prescribe their services or products to patients. 

Other direct or indirect personal or professional interests may include training opportunities, personal relationships, enhancement to professional reputation, consultancy or speaker fees, or research benefits. 

How To Spot and Address Conflict of Interest in Prescriber Recommendations 

You can spot a conflict of interest in prescriber recommendations by noticing the following red flags:

Frequent Recommendation of Branded Medications Over Generics

Generic medications contain the same active ingredient as brand-name medications but are typically less expensive. If your healthcare professional receives financial compensation from a pharmaceutical manufacturer, they may recommend the use of a brand-name medication without a clear reason or explanation. This could be a red flag that the healthcare professional has a conflict of interest. 

If you notice this, you should consider asking the following questions:

1. Can I take the generic version of the medication instead of the brand name since both have the same active ingredient?
2. Why are you prescribing the brand name version when there are generic versions available? 

Discussing the answers to these questions with your prescriber can ensure that the recommendation is based on clinical evidence with your health outcomes as the priority, rather than financial incentives.

Limited Discussions of Alternative Treatments

If your healthcare provider does not discuss alternative treatment options, such as non-medication therapies, over-the-counter medications, or lifestyle changes that may help improve your condition, consider asking why. 

Generally, healthcare providers who truly want to positively impact their patients’ health explore and discuss multiple effective alternative options before choosing the best one. 

Promotional Materials in the Clinic

Sometimes, prescribers in clinics or offices have promotional materials (such as posters, pens, or brochures) that advertise specific medications or newly launched medical devices. These advertising materials might indicate a close relationship between the prescribers and certain pharmaceutical companies. 

If you notice promotional materials, ask your prescriber about how effective the promoted products are and how they compare to alternative options.

Connection to Specific Pharmacies or Diagnostic Labs

Sometimes, medical professionals prescribe medications that are only available from a specific pharmacy or dispensary they recommend. They also may order lab tests (e.g., ultrasounds, CBC, or MRI) from a specific place only, even though they could also be done in other places. 

These red flags may suggest that the prescriber has a direct or indirect financial interest, such as receiving a commission or other benefits.

Pressure To Participate in Clinical Trials

Clinical trials are indeed essential for advancing medicine, but not all trials are appropriate for every patient. If you’re being pressured to join a trial without full disclosure of the risks and benefits, be sure to take time and ask more questions about it. 

The prescriber may be a part of the research team or may have a close connection to someone conducting that particular clinical trial. 

What are the Other Ways To Spot the Prescriber’s Potential Conflicts?

You can also spot the conflict of interest in your prescriber’s recommendations through the following ways:

Research the Prescriber’s Background 

In the U.S., an open payment database is available that tracks the payments made by pharmaceutical and medical device companies to healthcare providers. You can search your prescriber to see if they’ve received any significant compensation. 

Read Online Reviews

This is the best way to check the conflict of interest in your prescriber’s recommendation. Carefully read the reviews and feedback left by patients and see if any of them mentioned unnecessary treatment or expensive medication recommendations. 

Always Ask for a Second Opinion

Always get a second opinion from another healthcare provider when you feel your current prescriber is just promoting certain products. Most of the time, patients can receive recommendations for alternative options and more clarity through a second opinion. 

Research Over-Prescribed Treatments

Before you get your monthly prescriptions from the pharmacy, you should always research the medication online. Sometimes, the medication recommended by prescribers has limited effectiveness in certain conditions but is hyped due to heavy marketing. 

Takeaway

Conflict of interest in healthcare does not mean that a prescriber is acting unethically, but they do warrant vigilance. As a patient, being proactive and asking the right questions can help you identify potential biases and ensure your care is guided by what’s best for your health.