Ethical Depth: The Cure for Today’s Medical Industry
Conflicts of interest in the medical field, such as accepting gifts from pharmaceutical companies, pose a significant threat to the credibility of the medical industry, potentially undermining patient trust and the quality of healthcare provided. While policies like penalizing doctors or mandating disclosures have been proposed, they often miss the mark by not addressing the underlying psychological processes.
A new paper by Dr. Sunita Sah, physician-turned-organizational psychologist, at the Samuel Curtis Johnson Graduate School of Management, part of the Cornell SC Johnson College of Business, sheds light on this issue. Published in the Journal of General Internal Medicine, Sah’s paper, Deep Professionalism: Charting a Path for Effective Conflict‑of‑Interest Management in Medicine, explores why doctors may fall prey to these conflicts and proposes a novel approach called “deep professionalism.”
“Medical professionalism, which prioritizes patient welfare above personal interests, is a cornerstone of ethical practice. However, simply claiming professionalism may not be enough when economic incentives cloud physicians’ judgment. Surprisingly, my research indicates that an exaggerated sense of professionalism can contribute to greater unethical behavior,” said Sah.
Sah’s study, involving 400 managers, revealed that professionals with an inflated sense of professionalism were more inclined to accept conflicts of interest, mistakenly believing they could resist any unwanted influence. This is akin to dieters confident in their ability to resist unhealthy food are less likely to remove such foods from their home and thus end up eating more than they want.
According to Sah’s research, medical professionals who see themselves as unbiased are, paradoxically, more susceptible to bias after accepting a conflict of interest. Moreover, physicians with an inflated sense of professionalism fail to recognize their vulnerability in advance or their biases in hindsight, ultimately compromising patient care.
“Recognizing these pitfalls, the concept of “deep professionalism” appears to be a more effective approach to managing conflicts of interest,” said Sah. “Deep professionalism entails acknowledging one’s limitations and consistently prioritizing patient welfare over personal gain. It involves regular introspection, earnest humility, and a sincere commitment to ethical behavior.”
Sah believes that professionalism needs to be redefined as a practice rather than a character trait. Educating physicians on deep professionalism is critical to cultivating ethical medical environments. By cultivating an awareness of conflicts of interest and providing tools to recognize and address them in advance, medical training can empower physicians to navigate ethical challenges more effectively. Structural reforms, such as aligning provider incentives with patient interests, are also essential.
“It’s not just about what doctors do individually. The whole system needs to evolve and change. Hospitals should ban doctors from accepting gifts from drug companies altogether. This removes the temptation and helps ensure that physicians are not swayed by those gifts that are known to compromise clinical judgment. By fostering deep professionalism, the medical community can uphold its integrity and prioritize the well-being of patients above all else.”