So we need to talk about the elephants in the room; conflicts of interest. They can be difficult to spot and overcome.
According to the BC Health Regulators a conflict of interest is:
“A reasonable person could form the view that a professional’s ability and obligation to act in the patients best interest may be affected or influenced by other competing interests. Conflicts can be real, potential, or perceived. Circumstances can be financial, non-financial, direct, or indirect transactions with patients or others.”
Conflicts of interest may involve unconscious bias, and trust. Health care is built on trust. Patients trust their professional practitioner because their practitioner has special knowledge, skills, and abilities in which they use to provide safe, effective and ethical care.
Often professionals believe they are acting with professional integrity and without bias, “the power to rationalize… is remarkable,” Gray. Conflicts are problematic when a patient’s care is compromised.
There is a trust relationship between the public and the professional that the professional hired will fulfill their fiduciary duties. When conflicts of interest come in to play that duty gets distorted, as there is now a secondary interest in the peripheral vision of the professional. Often, ethics act as a gatekeeper, but what one must do by law and what one should do under ethical considerations are often different, conflicting ideas.
Your store offers free sight testing with the purchase of contact lenses or eyewear.
A patient informs you that they have a strict 75$ budget to spend on eyewear. You continually recommend higher priced eyewear because you believe it is better quality. You explain to the patient that in the long run they will spend less money, as the more expensive frames are less likely to break. You tell them that they should spend the extra 100$ now.
The patient is hesitant but ends up purchasing the higher priced eyewear because they believe that you (the eye health professional) recommended the particular eyewear with their best interest in mind. Their trust in you as a professional led them to make a purchase that they could not necessarily afford.
What’s the problem?
There are advantages to offering high end products however the patient outlined a limitation to you. It is your job as an eye care professional to work within these parameters in order to provide the best possible care. If you want to promote higher end products for the sake of your business, then you should also highlight the different options within the budget. Provide the patient with the information. Outline the advantages and disadvantages of each product. You should help the patient arrive at their own decision based on all the possible options presented to them. You should try to balance business and health in a manner that is beneficial to you and your patients.
What if you are involved in a conflict of interest?
If you believe you may be involved in a conflict of interest then disclose it! Being transparent with the public builds trust. It shows that you are dedicated to their care and that you’ve given them the tools they need to make informed decisions.