December
2003
Volume 27 •
No. 10
Medical
board clarifies policies
for conflicts of interests, human subjects
Stanford Hospital's Medical Board in November approved two policies designed to clarify that the hospital's policies for conflict of interest and human subjects apply fairly and consistently to all members of the medical staff.
Both new policies were sent to the Hospital Board for ratification.
The Conflict of Interest Policy for Medical Staff designates the chief of staff to review potential conflicts and recommend exceptions. Staff members in situations that might be a conflict of interest must make a full disclosure in writing to the chief of staff at Stanford Hospital (or at Packard Hospital if that is where privileges are granted). The chief of staff may grant an exception to the policy. But if an exception is not granted, the chief of staff should meet with the staff member to resolve the issue and/or institute disciplinary action under Medical Staff bylaws.
The policy requires that all staff members sign a brief acknowledgement - at time of appointment and reappointment - that they have read the policy and will comply with it. In addition, medical staff leadership and committee members will be asked to sign the form annually as part of their leadership or membership function. Previously, non-faculty members of the medical staff generally were not required to sign a conflict of interest statement. The present policy eliminates this inconsistency and emphasizes the medical center's commitment to safeguarding its integrity and reputation, explained Sarah DiBoise, chief hospital counsel.
"The biggest question that so far has arisen among physicians is whether or not owning stock in a company that supplies goods or services to SHC or whether having a spouse or dependent child who works for a vendor, needs to be reported," said DiBoise. "The short answer is that a conflict exists only when the physician is in a position to influence a decision that would result in financial gain for the staff member."
In other words, if a physician's spouse worked for a company supplying a product to the hospital, there would be no conflict as long as the physician had no influence over the purchase. Similarly, stock ownership in a company with a relationship to the hospital should be reported if the physician was in a position to influence a purchase decision for that company's product or service. Ownership without such influence need not generally be reported, she said.
The policy details some typical examples of potential conflict of interest situations involving purchase decisions, and such other issues as unauthorized disclosures of patient or hospital information for personal gain.
The new Institutional Review Board policy reaffirms Stanford Hospital's position that all human subjects research conducted at the hospital must have been approved by the Stanford University IRB.
The Medical Board was told that the policy explicitly designates the Stanford University Administrative Panel on Human Subjects as the entity responsible for reviewing human subjects protocols, including those initiated by non-faculty investigators. Information on the Stanford IRB is available at http://clinicaltrials.stanford.edu/sponsors/irb.html.
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