Device representatives in hospitals: are commercial imperatives driving clinical decision-making?

Author:

Grundy QuinnORCID,Hutchison Katrina,Johnson Jane,Blakely Brette,Clay-Wlliams Robyn,Richards Bernadette,Rogers Wendy A

Abstract

Despite concerns about the relationships between health professionals and the medical device industry, the issue has received relatively little attention. Prevalence data are lacking; however, qualitative and survey research suggest device industry representatives, who are commonly present in clinical settings, play a key role in these relationships. Representatives, who are technical product specialists and not necessarily medically trained, may attend surgeries on a daily basis and be available to health professionals 24 hours a day, 7 days a week, to provide advice. However, device representatives have a dual role: functioning as commissioned sales representatives at the same time as providing advice on approaches to treatment. This duality raises the concern that clinical decision-making may be unduly influenced by commercial imperatives. In this paper, we identify three key ethical concerns raised by the relationship between device representatives and health professionals: (1) impacts on healthcare costs, (2) the outsourcing of expertise and (3) issues of accountability and informed consent. These ethical concerns can be addressed in part through clarifying the boundary between the support and sales aspects of the roles of device representatives and developing clear guidelines for device representatives providing support in clinical spaces. We suggest several policy options including hospital provision of expert support, formalising clinician conduct to eschew receipt of meals and payments from industry and establishing device registries.

Funder

Canadian Institutes of Health Research

Publisher

BMJ

Subject

Health Policy,Arts and Humanities (miscellaneous),Issues, ethics and legal aspects,Health (social science)

Reference29 articles.

1. Angell M . The truth about the drug companies: how they deceive us and what to do about it. New York, NY: Random House, 2005.

2. Moynihan R , Cassels A . Selling sickness: how the worlds' biggest pharmaceutical companies are turning us all into patients. New York, NY: Nation Books, 2005.

3. Goldacre B . Bad pharma: how drug companies mislead doctors and harm patients. London, UK: Fourth Estate, 2012.

4. Can patients be sure they are fully informed when representatives of surgical equipment manufacturers attend their operations?

5. "I felt like the angel of death": role conflicts and moral distress among allied professionals employed by the US cardiovascular implantable electronic device industry;Mueller;J Interv Card Electrophysiol,2011

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3