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. 2023 Sep;116(9):295-306.
doi: 10.1177/01410768231181248. Epub 2023 Jun 8.

Policies on doctors' declaration of interests in medical organisations: a thematic analysis

Victoria Tzortziou Brown  1 , Margaret McCartney  2 , Patrycja Talaga  1 , Richard Huxtable  3 , Andrew Papanikitas  4 , Elizabeth David-Barrett  5
Affiliations

Policies on doctors' declaration of interests in medical organisations: a thematic analysis

Victoria Tzortziou Brown et al. J R Soc Med. 2023 Sep.

Abstract

Objectives: There has been growing concern about doctors' conflicts of interests (COIs) but it is unclear what processes and tools exist to enable the consistent declaration and management of such interests. This study mapped existing policies across a variety of organisations and settings to better understand the degree of variation and identify opportunities for improvement.

Design: Thematic analysis.

Setting: We studied the COI policies of 31 UK and international organisations which set or influence professional standards or engage doctors in healthcare commissioning and provision settings.

Participants: 31 UK and international organisations.

Main outcome measures: Organisational policy similarities and differences.

Results: Most policies (29/31) referred to the need for individuals to apply judgement when deciding whether an interest is a conflict, with just over half (18/31) advocating a low threshold. Policies differed on the perception of frequency of COI, the timings of declarations, the type of interests that needed to be declared, and how COI and policy breaches should be managed. Just 14/31 policies stated a duty to report concerns in relation to COI. Only 18/31 policies advised COI would be published, while three stated that any disclosures would remain confidential.

Conclusions: The analysis of organisational policies revealed wide variation in what interests should be declared, when and how. This variation suggests that the current system may not be adequate to maintain a high level of professional integrity in all settings and that there is a need for better standardisation that reduces the risk of errors while addressing the needs of doctors, organisations and the public.

Keywords: Competing interests (ethics); ethics; health policy; medical careers; professional conduct and regulation.

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Conflict of interest statement

All authors have completed the Unified Competing Interest form (available on request from the corresponding author) and declare: no support from any organisation for the submitted work, other than that the corresponding author’s academic position, is partly funded by the National Institute for Health Research. VTB, MM and AP are medical doctors in the NHS. Both VTB and MM have held elected roles within the Royal College of General Practitioners and have been involved in the development of the RCGP position on declaration of interests. MM has written extensively on the need for more transparency in relation to doctors’ COIs. Some of this has been paid journalism. VTB, MM, AP and RH have been members of ethics committees of NHS and/or health professional organisations. EDB has undertaken extensive research and published on corruption and anti-corruption policies and regulation. There are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1.
Figure 1.
Themes and subthemes of organisational policies on doctors’ declarations of interests. COI: conflict of interest.
See this image and copyright information in PMC

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