Conflict of Interest


Published: 31 October 2016

You just love that representative from the big pharmaceutical company who comes to the hospital every other month. He’s a great guy; jovial, well-dressed, and generous. You have to sit through a lecture about his product, but… hey, you get some free food.

What nurse doesn’t like free food, even if he or she has to sit through a boring sales pitch? What’s the harm?

Well, the harm may just be that you consciously or unconsciously give this medication to your patients. The sales guy is so nice, and you got some free food. What’s the harm in recommending the medication to your patient or using pens and clipboards with the name emblazoned across it? Actually, you might be inflicting harm, and you don’t even know it.

A Nurse’s Conflict

Many nurses are not in the position to prescribe medications or equipment. You are, however, someone the patient looks up to and respects. If you hand a patient a pen with one name instead of the other, you are tacitly agreeing that the medication is one the patient should consider.

If you are, for instance, putting the name of a specific brand of depression medication in the patient’s mind, are you sure that they wouldn’t be just as well served if they took Brand B or any number of other medications?

The problem also rears its ugly head when you have a hospital that controls various interests. Of course when the patient goes home they will be under the care of the hospital’s home healthcare program. Is this in the best interest of the patient, the nurse, the hospital, or anybody?

Medicine is a big business, and you are promoting goods and services whether you realise it or not.

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No Such Thing As a Free Lunch

In actuality, you can encounter harm by entertaining the sales reps. When they give you samples to ‘help out the patient‘ they are just about guaranteeing that they will have a customer. If Company A gives a sample, when the person has enough money, they will take Company A’s product, and not Company B. It serves the sales rep to be so generous because he or she knows that generosity may turn into a sale.

Some sales reps come in and shower the staff with gifts and food, in exchange for a short sales pitch. That’s fine, but shouldn’t every medicine have the benefit of this placement? Who is to say that the new product they are hawking is any better for the patient than the older or original products? When you take what the rep is giving, you set up in your mind that theirs is good for the patient.

It isn’t based on science or research – just the say so of the sales rep and your pleasure at some freebies. This free lunch buys him or her the hearts and minds of the respected medical establishment.

Navigating the Minefield

Let’s face it: you can’t very well get away from all promotional materials. Sales reps are good at their job primarily because they can convince you of the validity of their product. Some pharmaceutical companies even offer continuing education hours along with their sales pitch. This does not mean that you need to completely scorn anything that comes from pharmaceutical and equipment companies.

The truth is that you have to be aware. When the patient is considering a medication, procedure or service, ask yourself if you have anything to gain by recommending one over the other.

Do the people you employ have anything to gain over your recommendation?

Why are you recommending something in the first place?

Is it because you know for a fact that it will help the patient, or is it fresh in your mind from yesterday’s lunch meeting?

As medical companies continue to market to the consumer, nurses will often find themselves in the crossfire of conflicts of interest. It is important to always remember that the benefit of the patient must be considered first.


Portrait of Lynda Lampert
Lynda Lampert

Lynda is a registered nurse with three years experience on a busy surgical floor in a city hospital. She graduated with an Associates degree in Nursing from Mercyhurst College Northeast in 2007 and lives in Erie, Pennsylvania in the United States. In her work, she took care of patients post operatively from open heart surgery, immediately post-operatively from gastric bypass, gastric banding surgery and post abdominal surgery. She also dealt with patient populations that experienced active chest pain, congestive heart failure, end stage renal disease, uncontrolled diabetes and a variety of other chronic, mental and surgical conditions. See Educator Profile

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