Q&A: Conflicts of interest vs. dual relationships

Circumstances with the potential to undermine a case manager’s impartiality may arise, due to the possibility of a clash between self-interests and professional or public interests. Such circumstances are known as conflicts of interest. Other manifestations of conflicts of interest can occur when a person is in a position to derive personal benefit from certain actions or decisions made. For example, a case manager is employed by a hospital and also has a part-time role with a home health agency. All staff members of the home health agency receive an annual bonus if referral numbers increase by 25% annually. While the case manager might never dream of accepting the bonus, the appearance of a conflict of interest remains. The case manager must develop an immediate resolution plan, which could involve resigning from the part-time role.

Dual relationships are relatives of conflicts of interest. The concept describes when a case manager has multiple relationships with a client, whether professional, social, or business. It is understood across the interprofessional workforce that dual relationships can and will occur; at times, they are unavoidable. For example, you are case managing at a hospital within a small rural community. As a consequence of this role, you find yourself intervening with neighbors and even family members. The onus is always on the professionals involved to act in accordance with state laws and professional codes for their discipline, as well as with organizational policies. It might be acceptable for the case manager to maintain the assignment, but a contract and/or plan must be put in place to ensure appropriate professional boundaries are maintained. In some organizations, dual relationships are explicitly not permitted, and the client is immediately reassigned. These are tricky scenarios to master and often require ethical guidance from a colleague, mentor, or leadership to reconcile appropriately.

For more information, see The Essential Guide to Interprofessional Ethics in Healthcare Case Management . Need expert advice? Email your questions for consideration in the Revenue Cycle Daily Advisor. Note: We do not guarantee that all questions will be answered.