Exploring physician-pharmaceutical industry relationships

i-c48a85b82f9542974e8de35c72c35cca-4-28-07 doctor industry.jpg The latest issue of the New England Journal of Medicine reports that 94% of physicians in the U.S. receive gifts and benefits from pharmaceutical companies in the form of free food, drug samples and sports tickets, to name a few. Despite efforts by several organizations to regulate these relationships they appear to be quite common and may underscore doctors' professional decisions.

The authors of the study sent out a survey to which over 1500 physicians responded.

Most physicians (94%) reported some type of relationship with the pharmaceutical industry, and most of these relationships involved receiving food in the workplace (83%) or receiving drug samples (78%). More than one third of the respondents (35%) received reimbursement for costs associated with professional meetings or continuing medical education, and more than one quarter (28%) received payments for consulting, giving lectures, or enrolling patients in trials. Cardiologists were more than twice as likely as family practitioners to receive payments. Family practitioners met more frequently with industry representatives than did physicians in other specialties, and physicians in solo, two-person, or group practices met more frequently with industry representatives than did physicians practicing in hospitals and clinics.

The extent of these relationships appeared to vary among physicians and across different specialties.

The authors explained that just as academic scientist-industry relationships had been shown to have both benefits and risks physician-industry relationships may just as well harbor both benefits and risks.

The survey was conducted approximately one year after the Pharmaceutical Research and Manufacturers of America (PhRMA) implemented a new code of conduct governing physician-industry relationships among its members.

The code states that the interactions between company representatives and physicians should primarily benefit patients and enhance the practice of medicine. The code also discourages companies from giving physicians tickets to entertainment and recreational events, goods (e.g., golf balls and sporting bags) that do not convey a primary benefit to patients, and token consulting and advisory relationships that are used to reimburse physicians for their time, travel, or out-of-pocket expenses. The American Medical Association and the American College of Physicians have also adopted new codes that are similar to that of PhRMA.

The authors agreed that more in-depth surveys had to be done to better understand physician-industry relationships and exposed some limitations that future surveys would face. These included the increasing difficulty of obtaining physicians' responses to surveys or the tendency for some physicians to underreport their associations with industry.

The article concluded:

The relationships between physicians and industry are common and underscore the variation among such relationships according to specialty, practice type, and professional activities.


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