Curricular priorities for business ethics in medical practice and research: recommendations from Delphi consensus panels

Abstract

BackgroundNo published curricula in the area of medical business ethics exist. This is surprising given that physicians wrestle daily with business decisions and that professional associations, the Institute of Medicine, Health and Human Services, Congress, and industry have issued related guidelines over the past 5 years. To fill this gap, the authors aimed (1) to identify the full range of medical business ethics topics that experts consider important to teach, and (2) to establish curricular priorities through expert consensus.MethodsIn spring 2012, the authors conducted an online Delphi survey with two heterogeneous panels of experts recruited in the United States. One panel focused on business ethics in medical practice (n = 14), and 1 focused on business ethics in medical research (n = 12).ResultsPanel 1 generated an initial list of 14 major topics related to business ethics in medical practice, and subsequently rated 6 topics as very important or essential to teach. Panel 2 generated an initial list of 10 major topics related to business ethics in medical research, and subsequently rated 5 as very important or essential. In both domains, the panel strongly recommended addressing problems that conflicts of interest can cause, legal guidelines, and the goals or ideals of the profession.ConclusionsThe Bander Center for Medical Business Ethics at Saint Louis University will use the results of the Delphi panel to develop online curricular resources for each of the highest rated topics.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6920-14-235) contains supplementary material, which is available to authorized users.

Is the Delphi method valid for business ethics? A survey analysis

“…This differentiation is important for this paper's purpose, namely, to show that it is possible to use the Delphi method for resolving research problems in business ethics, and it also enables us to understand that its applicability in the field of business ethics could be useful in those types as well. In general, the Policy Delphi has been used in business for the medicine curriculum [25], as well as for establishing cultural values [58], the value chain [5], and defining the business intelligence process [11]. The Decision Delphi has commonly been used to evaluate business models [48,52,53].…”

Teaching Medical Business Ethics: An Introduction to the Bander Center’s Casebook

“…Bander Center-affiliated faculty and staff conducted a Delphi consensus panel project "to establish priorities for curricula in business ethics in medical practice and research" [1]. The Delphi process, a structured communication technique in which a group of experts are polled and their responses used to generate further polls for them to respond to, is used to establish a consensus among experts on topics that involve subjective judgments rather than analytical problem solving, such as policy priorities or educational curricula [9].…”

“…Medical practice panelists had "expertise in medical practice, medical education, medical ethics, medical sociology, health care administration, health economics, health law, outcomes research, and government oversight" [1]. Medical research panelists had "expertise in medical research, research training, research ethics, social science, research administration, health economics, research regulations, and government oversight" [1]. Invitation to participate on the panels was done by e-mail, and all participants freely consented to be members of the panels.…”

“…The Delphi panels were surveyed in two phases. The first phase focused on data collection by giving participants open-ended prompts like "Please list up to 10 topics that you consider most important to address within educational programs for physicians-intraining in the domain of business ethics in medical practice" [1]. The medical practice panel produced 103 responses, which the researchers grouped into 14 distinct topics.…”

“…The Bander Center for Medical Business Ethics was established in 2007 at Saint Louis University with an endowment from the BF Charitable Foundation to promote "ethical business practices in medical care and research through the development of training and investigation responsibilities for medical students, residents and physicians in practice" [1]. The center defines medical business ethics (MBE) as "the ethical engagement of the financial dimension of medical practice and research" [1]. Many of physicians' decisions related to clinical practice or medical research have a business component.…”