Conflict of Interest: The Attitude of Iranian Physicians Involved in Breast Cancer Managemen

Evidence on physician's attitude toward conflict of interest is scant on a global scale and almost non-existent in a regional/national scale. This investigation is a pioneer to evaluate this issue in the Middle East and Iran.
We invited physicians of different (sub)specialties/educational levels who were engaged in breast cancer management to take an online 13-question survey regarding their attitude toward different statements on conflict of interest. The responses were then collected and analyzed.
The questionnaire was returned by 91 out of 157 recipients (response rate = 57.9%). Based on the answers, advertisement by pharmaceutical sales representatives in academia was considered inappropriate (63.8%) and influential on clinical practice (80.2%). It was the belief of 59.4% of participants that local practice norms defined whether or not to accept travel grants. According to these norms, they might have accepted paid travels (53.9%), but not financial offers (72.2%). It was acceptable to deliver (74.8%) or attend (68.9%) a speech when a financial/scientific relationship with industrial companies existed and 93.4% believed that the disclosure and transparency rules should be respected in such situations. Physician-industry financial contracts were generally unfavorable (60.5%), especially when it came to prescribing a drug among other equally effective choices (71.1%). The majority of respondents (92.3%) stated that they would choose the best approach for the patients regardless of possible prejudgments on conflict of interest.
The observed variation in physician's standpoints highlights the necessity for more comprehensive training and implementation of rigorous protocols regarding conflict of interest.