Using institutional theory to explore disagreements about 'conflict of interest' in medicine

Wendy Lipworth, Kathleen Montgomery

Research output: Contribution to conferenceAbstractpeer-review


Medical professionals are afforded considerable professional autonomy, and in return, they are expected to place responsibilities to their patients and research participants above other commitments. In reality, medical professionals are increasingly reliant on health-related industries, such as the pharmaceutical industry, and the relationships they form with these industries have the potential to create commitments that compete with their ‘primary’ responsibilities. This situation, referred to as ‘conflict of interest’ (COI), has attracted highly polemical debate. We analyze a recent discourse surrounding COI in biomedical publishing to explore the proposition that ongoing debates about COI reflect two potentially incompatible institutional logics, finding strong evidence of a tension between market and professional logics in debates about COI. Drawing from Besharov and Smith’s (2014) idea that organizational conflict can be understood in terms of the ‘compatibility’ and ‘centrality’ of competing institutional logics, we found that the conflict between these logics is characterized by moderate compatibility and high centrality. Although the opposing actors espouse support for the same goals of improving outcomes for patients and building trust in science and medicine, their means for achieving these goals and their guiding principles diverge markedly, reflecting the different priorities and assumptions of the two logics. We conclude with observations about how to move beyond the current impasse in debates about COI, highlighting the need to resolve important points of difference regarding evidence standards and application of the ‘precautionary principle’.
Original languageEnglish
Publication statusPublished - Nov 2017
Externally publishedYes
EventAcademy of Management Annual Meeting - Anaheim, United States
Duration: 5 Aug 20169 Aug 2016


ConferenceAcademy of Management Annual Meeting
Country/TerritoryUnited States


  • conflict
  • institutional logistics
  • professional autonomy


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