Drug industry gifts OK with some physicians

Most physicians and doctors-in-training still have a positive attitude toward marketing-oriented activities by pharmaceutical companies and device manufacturers, even though some institutions and national specialty societies have adopted policies that limit or ban such practices, a new study shows.

For example, 72% of 590 surveyed doctors and medical students said sponsored lunches were appropriate, according to the study in the June Archives of Surgery. Nearly 60% said samples improve care for their patients, and 71% said pharmaceutical and device company money is useful for funding residency programs.

There were limits, though. About three in four respondents believed gifts valuing more than $50 were unacceptable. Nearly 90% thought vacations were inappropriate.

Study authors in 2008 polled faculty and medical trainees at the Mount Sinai School of Medicine consortium, which includes 11 hospitals throughout New York City (link).

Mount Sinai School of Medicine implemented a policy in 2007 that bans or limits marketing-related interactions between physicians and industry. Other institutions have adopted similar limits, and some specialty societies, including the American Board of Internal Medicine, have adopted guidelines.

"We were surprised overall to find the positive attitudes, especially at our institution that has the restrictions in place," said study co-author and internist Deborah Korenstein, MD, an associate professor at Mount Sinai's medical school.

But a physician's specialty, training level and familiarity with guidelines about gifts from drug companies and medical device manufacturers can influence how positively he or she views the marketing.

Physicians from surgical specialties were more likely to have a positive attitude toward industry and more likely to deem as acceptable some gifts, such as residency funding and travel reimbursement for attending lectures, the study showed. Pediatricians held less favorable attitudes. And nonattending physicians held more positive attitudes toward receiving meals, textbooks and drug samples.

The study also found that educating physicians about policies may make them less accepting of gifts, even small ones. Physicians familiar with Mount Sinai's guidelines (54%) were less likely to agree that drug samples improve patient care compared with those who were not familiar with the policy.

"Our findings suggest the importance of physician education about the influence of industry, particularly for trainees and surgical specialists who may be less aware of the influence of industry and who may in fact be governed through their specialty bodies by more permissive guidelines," study authors wrote. "However, large changes in physician attitudes are likely to require shifts in the cultural environment of medicine."