Camp Mark W, Gross Allan E, McKneally Martin F
From the Department of Surgery, University of Toronto, (Camp, Gross, McKneally); the Joint Centre for Bioethics, University of Toronto, (McKneally); the Hospital for Sick Children (Camp); and Mount Sinai Hospital, (Gross) Toronto, Ont.
Can J Surg. 2015 Oct;58(5):323-9. doi: 10.1503/cjs.000815.
Over the past decade, revelations of inappropriate financial relationships between surgeons and surgical device manufacturers have challenged the presumption that surgeons can collaborate with surgical device manufacturers without damaging public trust in the surgical profession. We explored postoperative Canadian patients' knowledge and opinions about financial relationships between surgeons and surgical device manufacturers.
This complex issue was explored using qualitative methods. We conducted semistructured face-to-face interviews with postoperative patients in follow-up arthroplasty clinics at an academic hospital in Toronto, Canada. Interviews were audiotaped, transcribed and analyzed. Patient-derived concepts and themes were uncovered.
We interviewed 33 patients. Five major themes emerged: 1) many patients are unaware of the existence of financial relationships between surgeons and surgical device manufacturers; 2) patients approve of financial relationships that support innovation and research but are opposed to relationships that involve financial incentives that benefit only the surgeon and the manufacturer; 3) patients do not support disclosure of financial relationships during the consent process as it may shift focus away from the more important risks; 4) patients support oversight at the professional level but reject the idea of government involvement in oversight; and 5) patients entrust their surgeons to make appropriate patient-centred choices.
This qualitative study deepens our understanding of financial relationships between surgeons and industry. Patients support relationships with industry that provide potential benefit to current or future patients. They trust our ability to self-regulate. Disclosure combined with appropriate oversight will strengthen public trust in professional collaboration with industry.
在过去十年中，外科医生与手术器械制造商之间不当财务关系的曝光，对外科医生能够与手术器械制造商合作而不损害公众对外科职业信任这一假设提出了挑战。我们探究了加拿大术后患者对外科医生与手术器械制造商之间财务关系的了解和看法。
采用定性方法探讨这一复杂问题。我们在加拿大多伦多一家学术医院的关节置换术后随访诊所，对术后患者进行了半结构化面对面访谈。访谈进行了录音、转录和分析。发现了患者提出的概念和主题。
我们采访了33名患者。出现了五个主要主题：1）许多患者不知道外科医生与手术器械制造商之间存在财务关系；2）患者赞成支持创新和研究的财务关系，但反对仅使外科医生和制造商受益的财务激励关系；3）患者不支持在同意过程中披露财务关系，因为这可能会将焦点从更重要的风险上转移开；4）患者支持专业层面的监督，但反对政府参与监督的想法；5）患者信任他们的外科医生做出以患者为中心的适当选择。
这项定性研究加深了我们对外科医生与行业之间财务关系的理解。患者支持与行业建立对当前或未来患者有潜在益处的关系。他们信任我们自我监管的能力。披露与适当监督相结合将增强公众对与行业专业合作的信任。
