{"id":12554,"date":"2018-07-23T08:00:19","date_gmt":"2018-07-22T22:00:19","guid":{"rendered":"https:\/\/www.bitemagazine.com.au\/?p=12554"},"modified":"2018-07-23T15:29:47","modified_gmt":"2018-07-23T05:29:47","slug":"conflicts-of-interest-in-dentistry","status":"publish","type":"post","link":"https:\/\/www.bitemagazine.com.au\/conflicts-of-interest-in-dentistry\/","title":{"rendered":"Conflicts of interest in dentistry"},"content":{"rendered":"<figure id=\"attachment_12556\" aria-describedby=\"caption-attachment-12556\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" class=\"wp-image-12556 size-full lazyload\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" data-src=\"https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives.jpg\" alt=\"conflicts of interest\" width=\"1024\" height=\"957\" data-srcset=\"https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives.jpg 1024w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-300x280.jpg 300w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-768x718.jpg 768w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-696x650.jpg 696w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-449x420.jpg 449w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-899x840.jpg 899w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-161x150.jpg 161w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-80x75.jpg 80w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-203x190.jpg 203w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-112x105.jpg 112w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><noscript><img decoding=\"async\" class=\"wp-image-12556 size-full lazyload\" src=\"https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives.jpg\" alt=\"conflicts of interest\" width=\"1024\" height=\"957\" srcset=\"https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives.jpg 1024w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-300x280.jpg 300w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-768x718.jpg 768w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-696x650.jpg 696w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-449x420.jpg 449w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-899x840.jpg 899w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-161x150.jpg 161w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-80x75.jpg 80w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-203x190.jpg 203w, https:\/\/www.bitemagazine.com.au\/wp-content\/uploads\/2018\/07\/incentives-112x105.jpg 112w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/noscript><figcaption id=\"caption-attachment-12556\" class=\"wp-caption-text\">Dental practitioners face a range of potential conflicts of interest.<\/figcaption><\/figure>\n<h2>Are dentists influenced by gifts and incentives, and should professional codes of conduct be updated to provide clearer guidelines for interactions with patients, colleagues and industry so as to avoid conflicts of interest in dentistry? By Angela Tufvesson<\/h2>\n<p>Ever accepted a box of chocolates or bottle of wine from a grateful patient or specialist on the receiving end of a referral? Likewise, many dentists receive free samples from visiting pharmaceutical company reps. These practices may seem entirely innocent, but evidence suggests that practitioners may be unaware of their potential influence on professional behaviour, argue two University of Sydney academics in a recent paper published in the Journal of Law and Medicine.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<h3>All wrapped up<\/h3>\n<p>According to the authors, Dr Alexander Holden and Professor Heiko Spallek, the profession is exposed to influence and incentives from three main sources: patients, professional colleagues and industry, especially the\u00a0pharmaceutical and medical devices industries.<\/p>\n<p>Dr Holden says many specialists send gifts to referring practices at Christmas and other holiday times, often accompanied by an invitation to a lecture where CPD is offered. \u201cThere\u2019s no immediate sense of \u2018you sent me a referral therefore I\u2019m going to give you some sort of reward\u2019 but, let\u2019s be honest, you don\u2019t\u00a0get a hamper unless you\u2019ve sent some sort of referral at some point in the preceding year,\u201d he says.<\/p><div class=\"bitem-article-desktop-720x300-in-text\" id=\"bitem-4040580503\"><!-- Bite 720x300 [async] -->\r\n<script type=\"text\/javascript\">if (!window.AdButler){(function(){var s = document.createElement(\"script\"); s.async = true; s.type = \"text\/javascript\";s.src = 'https:\/\/servedby.engagemedia.com.au\/app.js';var n = document.getElementsByTagName(\"script\")[0]; n.parentNode.insertBefore(s, n);}());}<\/script>\r\n<script type=\"text\/javascript\">\r\nvar AdButler = AdButler || {}; AdButler.ads = AdButler.ads || [];\r\nvar abkw = window.abkw || '';\r\nvar plc705185 = window.plc705185 || 0;\r\ndocument.write('<'+'div id=\"placement_705185_'+plc705185+'\"><\\\/'+'div>');\r\nAdButler.ads.push({handler: function(opt){ AdButler.register(165450, 705185, [720,300], 'placement_705185_'+opt.place, opt); }, opt: { place: plc705185++, keywords: abkw, domain: 'servedby.engagemedia.com.au', click:'CLICK_MACRO_PLACEHOLDER' }});\r\n<\/script><\/div>\n<p>Similarly, pharmaceutical companies, supply companies and other firms that support dentistry often visit practices and offer \u2018lunch and learn\u2019 sessions. \u201cThey\u2019ll bring food in exchange for your time over your lunchbreak to talk about their products and perhaps bring some free samples as well,\u201d says Dr Holden. \u201cAgain, we can say that\u2019s perfectly innocent but could a patient or outside member of the public look at that and say, \u2018Well, does that somehow affect your decision-making ability?\u2019\u201d<\/p>\n<p>Crucially, the paper argues that practitioners are less likely to be aware of these influences courtesy of a phenomenon dubbed \u2018bias blind spot\u2019.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<p>\u201cMost people would be very aware of these concepts but would never think it might happen to them,\u201d says Dr Holden. \u201cThat\u2019s the definition of bias blind spot\u2014this idea that most people will point out the splinter in someone\u2019s eye while forgetting the splinter in their own. For example, if you ask colleagues if they suffer from professional bias, the answer will probably be no. If you ask them if their colleagues have a problem with bias, they might say that some do.\u201d<\/p>\n<h3>Industry guidelines<\/h3>\n<p>So, how does the dental profession instruct practitioners to manage these sorts of potential conflicts? The Dental Board of Australia\u2019s Code of Conduct says practitioners must recognise and resolve conflicts in the best interests of patients, explaining that good practice involves skills such as recognising the influence of pharmaceutical companies, not offering inducements to colleagues and not accepting gifts from patients other than \u201ctokens of minimal value such as flowers or chocolates\u201d.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<p>Dr Hugo Sachs, president of the Australian Dental Association (ADA), says the organisation is a signatory to a consensus statement supported by the Asia Pacific Economic Forum (APEC) that details values and ethical principles for the healthcare sector, including a commitment to managing conflicts of interest and bias. Plus, he says specific ADA policies govern behaviour in potentially tricky areas such as sponsorship of CPD activities and interaction with dental equipment and material suppliers.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<blockquote>\n<h5>\u201cWhen it comes to, for example, dentists paying other dentists for incentives for referrals and things like that, I haven\u2019t heard of it, and I\u2019ve been a practitioner for coming up to 39 years.\u201d\u2014Dr Hugo Sachs, president, ADA<\/h5>\n<\/blockquote>\n<p>Beyond these policies, however, practitioners are expected to be guided by individual ethics and transparency. \u201cWhen it comes to, for example, dentists paying other dentists for incentives for referrals and things like that, I haven\u2019t heard of it, and I\u2019ve been a practitioner for coming up to 39 years,\u201d says Dr Sachs. \u201cAnd [when it comes to pharmaceutical companies] you occasionally get free samples but from my viewpoint there\u2019s never been any pressure.\u201d<\/p>\n<p>In contrast, the Australian Dental Industry Association (ADIA) has banned gifts provided by suppliers to dental professionals purchasing therapeutic products. Chief executive officer Troy Williams says the change recognises that the ethical promotion of dental products is central to the trust-based framework within which\u00a0healthcare professionals advise\u00a0and treat patients.<\/p>\n<p>\u201cThe industry prohibition on the offering of gifts such as consumer electronics in connection with supplying a therapeutic good is abundantly clear,\u201d he says. \u201cIt\u2019s black and white. There\u2019s no room for misinterpretation\u2014gifts of that nature can\u2019t be offered.<\/p>\n<p>\u201cThere is no corresponding prohibition on asking for gifts or receiving them in the professional codes. The simple fact is that the industry\u2019s expectations of its members are clearer and more stringent than those of dentists and allied oral healthcare professionals as set by the Dental Board of Australia and the\u00a0relevant professional bodies.\u201d<\/p>\n<h3>Calling for change<\/h3>\n<p>Williams says codes of conduct for dental professionals should be updated to reflect the changes in the dental industry. \u201cIt\u2019s the ADIA\u2019s view that the obligations of the dental industry and dental profession should be mutually supportive,\u201d he says. \u201cIn the same way that manufacturers and suppliers are unable to offer gifts with the supply of therapeutic products, dental and oral healthcare professionals should be unable to seek or accept them.\u201d<\/p>\n<p>Likewise, Dr Holden says current guidelines don\u2019t exist beyond the bare minimum, and he believes introducing new codes of conduct to govern gifts and incentives will help to ensure the profession retains integrity.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<p>\u201cThe Dental Board of Australia hints at some things being problematic but doesn\u2019t necessarily come out with black and white guidance, so there is still a lot left to the judgement of individual practitioners,\u201d he says.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<p>\u201cThere\u2019s an opportunity for professional organisations such as the ADA to really take the lead. Currently there is very little within their guidelines that would support a dentist, for example, making decisions about whether or not a gift at Christmas time from a referral practice is acceptable.\u201d<\/p>\n<p>But, thankfully, that\u2019s not to say the profession needs to employ a nanny-state approach. \u201cWe recognise that dentists work very hard and sometimes it\u2019s nice to have an extra thank you from patients other than what they\u2019re obliged to pay for services,\u201d says Dr Holden. \u201cWe don\u2019t\u00a0think taking a blanket approach\u00a0to anything is helpful but an approach that\u2019s based on thoughtful practice is definitely needed.\u201d<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Are dentists influenced by gifts and incentives, and should professional codes of conduct be updated to provide clearer guidelines for interactions with patients, colleagues and industry so as to avoid conflicts of interest in dentistry? By Angela Tufvesson Ever accepted a box of chocolates or bottle of wine from a grateful patient or specialist on [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":12556,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[691],"tags":[4594,684,4595],"class_list":{"0":"post-12554","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-your-business","8":"tag-conflicts-of-interest","9":"tag-featured","10":"tag-incentives"},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.9 (Yoast SEO v25.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Conflicts of interest in dentistry - Bite Magazine<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.bitemagazine.com.au\/conflicts-of-interest-in-dentistry\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Conflicts of interest in dentistry\" \/>\n<meta property=\"og:description\" content=\"Are dentists influenced by gifts and incentives, and should professional codes of conduct be updated to provide clearer guidelines for interactions with patients, colleagues and industry so as to avoid conflicts of interest in dentistry? 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