Physicians’ Relationships with Industry – Update: New Policy Approved

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    Stakeholder feedback

    View the feedback we received to our online survey

    View the comments posted to our online discussion page

    quick poll results

    Would your trust in your physician be negatively affected if you knew that he or she accepted modest meals paid for by pharmaceutical companies?

    • No (56%, 175 Votes)
    • Yes (40%, 123 Votes)
    • Not sure (4%, 13 Votes)

    Total Voters: 311

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    Our Process

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    The College’s Physicians’ Relationships with Industry: Practice, Education and Research policy received final approval from Council on September 4, 2014, and is now an official policy of the College of Physicians and Surgeons of Ontario.

    We would like to thank all those who submitted their feedback and contributed to this policy review. While not every comment or suggested edit was incorporated into the final policy, all comments were carefully considered in light of current practice issues, the values and duties of medical professionalism, and the College’s mandate to protect the public.

    Below is a brief summary of the policy review process, including an overview of the feedback received and revisions undertaken:

     

    people

    Who we heard from

    • 318 submissions were received in response to this consultation.
    • While the majority of feedback was received from physicians, we also heard from a number of other important stakeholders, including key industry associations, including Rx&D, MEDEC, AstraZeneca and Janssen.
    View the feedback: Survey reportWritten Comments

    What we heard

    Other important considerations

    • Broadly speaking, respondents expressed support for the policy.
    • Industry respondents noted significant alignment between the draft policy and their own practices and Codes of Ethics.
    • Of those respondents who were critical of the draft policy, many expressed the following opinions:
        • The policy should not permit physicians to accept meals of any value, drug samples, or patient teaching aids from industry, as these constitute gifts.
        • The policy should permit physicians to organize and/or present at industry “drug dinners”.
        • The policy should permit physicians to accept funding from industry to attend educational events.
        • The policy should permit physicians to engage in education on behalf of a company while serving on their advisory or consultation board.
    • In addition to the feedback, we considered a wide range of other information while developing the final policy. This included:
        • Relevant legislation.
        • Policies and guidelines of other organizations, including industry associations and medical regulators within Canada and internationally.
        • An extensive review of the literature examining the impact of industry relationships on physician behaviour.
        • An important conclusion of this research is that interactions between physicians and industry can influence a physician’s clinical judgment, even where the physician believes otherwise.

    How we responded to your feedback

    • A significant number of revisions were made to the draft policy in response to your feedback. These revisions ranged from minor editorial changes to significant reevaluations of key expectations.
    • Two of the major revisions are highlighted below, as are two important instances where revisions were not made:
    Policy decision Rationale
    • The section on CME/CPD was revised to permit physicians to organize and/or present at educational events directly organized and/or funded by industry, including “drug dinners”.
    • Respondents argued that there was value in industry organized and/or funded educational events, especially where other educational opportunities were not available.
    • Physicians who participate in these events must meet additional expectations as set out in the final policy.
    • Revisions were made to permit physicians to engage in education while sitting on industry consultation or advisory boards.
    • Physicians who sit on consultation or advisory boards have unique expertise that makes them well suited to engage in education, provided that their relationships with industry are disclosed.
    • The final policy permits physicians to accept meals of modest value, patient teaching aids and free drug samples from industry.
    • Despite some objections, most respondents were comfortable with physicians accepting meals of modest value in limited circumstances.
    • Patient teaching aids and free drug samples benefit patients while carrying minimal risk of influencing physician behaviour.
    • The final policy retains the prohibition against accepting industry funding to attend CME/CPD events.
    • This practice entails significant benefit to physicians which creates a high risk of influence.

    The final policy

    • The Physicians’ Relationships with Industry: Practice, Education and Research policy received final approval from CPSO Council on September 4, 2014. It is now a formal policy of the College of Physicians and Surgeons of Ontario.


    Read the Final Policy

     Key messages of the final policy:

    • Industry plays a valuable and legitimate role in medicine, and the policy does not discourage appropriate physician-industry interactions.
    • Some interactions can give rise to ethical dilemmas and conflicts of interest that must be recognized and managed.
    • The policy assists physicians in understanding and managing their relationships with industry appropriately.