is aware that behaviors are shaped not only by personal commitments but also by cultural and social forces. The environment in which health care professionals carry out research, teach, provide clinical care, and develop practice guidelines should promote and reinforce a professional’s internal tendency to avoid relationships that pose an unacceptable risk of improperly influencing his or her judgment. The same is true for institutions. Their commitment to improve the content and application of conflict of interest policies is more likely to be effective if strong and consistent support from multiple independent organizations exists alongside government regulations. Thus, Recommendation 9.1 calls for an array of public and private groups (that is, supporting organizations) to create incentives to promote the widespread acceptance of policies to limit and manage conflicts of interest.

RECOMMENDATION 9.1 Accreditation and certification bodies, private health insurers, government agencies, and similar organizations should develop incentives to promote the adoption and effective implementation of conflict of interest policies by institutions engaged in medical research, medical education, clinical care, or practice guideline development. In developing the incentives, these organizations should involve the individuals and the institutions that would be affected.

A number of specific suggestions about incentives were discussed above and in the earlier chapters on medical research, education, and practice and practice guideline development. Box 9-1 summarizes these and other

BOX 9-1

Examples of Methods That Supporting Organizations Can Use to Strengthen Conflict of Interest Policies

Oversight bodies that oversee or regulate medical education and practice

  • Accreditation and specialty certification bodies could set standards for the adoption of conflict of interest policies by organizations that offer undergraduate, graduate, and continuing medical education. These bodies could also collect and make public information on the educational institutions that follow those standards.

  • State licensing boards could require that the continuing medical education courses required for relicensure be provided only by institutions that have adopted conflict of interest policies and other relevant recommendations presented in this report.



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