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OPHTHALMOLOGY BUSINESS 76 August 2016 One tip is to disclose interests to patients. Dr. Banja suggested that relationships with industry at least be published in some written form. "That way you don't get into the 'I was never told that …' sort of argu- ment with patients," Dr. Banja said. He said working with a larg- er institution can be a safeguard, explaining that institutions like universities, for example, insist on examining a physician's relationship with industry. "Physicians typically hate that, but it's usually the case that the university simply wants to know what their employee is up to and to protect him or her from doing some- thing stupid," Dr. Banja said. "If no such external agency or entity exists —that is, if you're self-employed or working in a clinic and it's just you calling the shots—your ethical behavior is going to largely be a function of your personal, moral conscience." Dr. Banja said the potential for someone's moral perception to be swayed by greed and self-interest requires medical ethicists, peers, and other watchdogs to "continue to remind health providers of their professional obligations, and we hope we have recruited men and women of good character into the professional ranks." Dr. Trattler agreed that despite increased education about medical ethics and industry, the conversa- tion should be ongoing. "I think the topic is definitely a worthwhile discussion point, but we want to be fair and balanced and not demonize physicians for working with indus- try because all of the innovations we have today come out of those relationships." EW Reference 1. Coyle SL. Physician-industry relations. Part 1: individual physicians. Ann Intern Med. 2002;136:396–402. Contact information Banja: jbanja@emory.edu Carlat: Daniel.Carlat@gmail.com Hoffman: rshoffman@finemd.com Trattler: wtrattler@gmail.com Dr. Hoffman said he is lucky to consult for two companies that use him as a consultant and not a salesman. "They run ideas by me, get my feedback, and perhaps get my opin- ion on logistics for instrumentation or improvements in their technolo- gy," he said. "I think that currently very few 'consultants' are being used as consultants and are groomed as salespeople for industry products. "If an ophthalmologist is being paid for his or her opinion or true consulting, I see no ethical dilem- ma," Dr. Hoffman continued. "It is when the ophthalmologist becomes a salesperson for company products that an ethical issue can develop." John Banja, PhD, medical ethi- cist and professor, Emory University Center for Ethics, Atlanta, said he thinks a proper relationship between physicians and industry is one that "doesn't unreasonably compromise the physician's clinical or scientific objectivity." Dr. Banja offered some advice to those entering into or already in a relationship with industry. Industry continued from page 74

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