Interaction with drug industry reps needs to be professional, educational

Regarding "Buy your own lunch" (Article, Jan. 16): No Free Lunch founder Bob Goodman, MD, addresses an issue that has bothered me since residency.

We often were taken out for lunch by drug representatives looking to establish a relationship with young doctors-in-training.

By many residents, these events (and others more extravagant), were eagerly anticipated.

I had an ethical antipathy toward these meals, but I often went along with the crowd and even set up some of them myself as team-building events.

But when I heard comments from my fellows, only half in jest, of "Let's use Brand X because that rep takes us to the best restaurant," I realized that the pharmaceutical companies were achieving their objectives, and that physicians were compromised. And I saw this over and over.

As a surgeon, I don't have day-to-day encounters with drug reps in the office, but my sense is things have gotten better. For instance, our multispecialty clinic imposes significant restrictions on rep visits.

There are some common-sense guidelines published by the organizations listed below Dr. Goodman's interview.

Are they enough, in a profession struggling to maintain its reputation, or should we bring out the nuclear option of a total ban on gifts and samples? I guess that hinges on whether lunch really is free.

Our encounters with industry representatives need to be professional and educational.

New, better products do come along, and the reps are important in explaining them. But industry contacts should not be the only source of information, nor should any of us feel an obligation to the person or product as we learn.

A moral compass, an awareness that freebies are neither expected nor desired, will keep us professional, not promotional.

Andrew C. McIvor, MD, Portland, Ore.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/03/06/edlt0306.htm.