Legally Speaking
 
February 2021
By Bryan Salte, Associate Registrar and Senior Legal Counsel, CPSS

Conflicts of Interest in Medical Practice

The College has recently dealt with situations in which it appears that physicians may have engaged in a conflict of interest. The College has a Conflict of Interest Guideline. The College also has adopted Bylaw 9.1 addressing Conflict of Interest. That bylaw defines having a conflict of interest as unprofessional conduct.

Physicians must be particularly careful about their financial arrangements with individuals or organizations that provide services to or sell products to their patients. 

The College wants to remind physicians of the following:

  • Renting premises from a supplier who supplies medical goods or services to the physicians’ patients (e.g. pharmacies) is a conflict of interest unless the rent is normal for the area and the rent is not related to the referral of patients.
  • Receiving a benefit from a supplier who supplies medical goods or services to the physician’s patients is a conflict of interest.
  • “Steering” patients to a pharmacy is contrary to the Code of Conduct {bylaw 7.2 “Respect for Others” paragraph (d)}

Paragraphs 22 through 27 of The Code of Ethics and Professionalism of the Canadian Medical Association are incorporated into College bylaw 7.1 . Those paragraphs state:

22. Recognize that conflicts of interest may arise as a result of competing roles (such as financial, clinical, research, organizational, administrative, or leadership).

23. Enter into associations, contracts, and agreements that maintain your professional integrity, consistent with evidence-informed decision-making, and safeguard the interests of the patient or public.

24. Avoid, minimize, or manage and always disclose conflicts of interest that arise, or are perceived to arise, as a result of any professional relationships or transactions in practice, education, and research; avoid using your role as a physician to promote services (except your own) or products to the patient or public for commercial gain outside of your treatment role.

25. Take reasonable steps to ensure that the patient understands the nature and extent of your responsibility to a third party when acting on behalf of a third party.

26. Discuss professional fees for non-insured services with the patient and consider their ability to pay in determining fees.

27. When conducting research, inform potential research participants about anything that may give rise to a conflict of interest, especially the source of funding and any compensation or benefits.

The College encourages physicians to review and be familiar with College bylaws and policies. They are available on the College website.

We encourage any physician who has a concern about possible conflicts of interest to discuss those concerns with College staff.

 

  Bryan Salte is Associate Registrar and Senior Legal Counsel at the College of Physicians and Surgeons of Saskatchewan.