In an article released today by The New England Journal of Medicine (Physician–Industry Relationships ), it looks as if things haven't changed all that much. In a national survey of 3,167 physicians, the authors report that 94 percent reported receiving gifts of some kind.
- 83% received food in the workplace
- 78% received drug samples
- 35% received reimbursement for costs associated with professional meetings or continuing medical education
- 28% received payments for consulting, giving lectures, or enrolling patients in trials
- 7% received tickets to cultural or sporting events
You can read The New England Journal of Medicine article at Physician–Industry Relationships .
You can purchase my August 2002 article from The New York Times archives at THE RIGHT THING; Just Saying No to Gifts From Drug Makers. (If you are a college student or professor with an .edu address, you should be able to access this as well as other Times-Select articles for free.)
Joe Fahy of the Pittsburgh Post-Gazette wrote about the NEJM findings this morning at Most doctors still take gifts from drug, device firms. And Denise Gellene wrote about it in the Los Angeles Times at Doctor freebies common, study says.
My doctors frequently use clipboards with drug company logos on them, or post-it notes, or pens. I always think "really? are you really so cheap that you're willing to take a free clipboard and become a human billboard?" And I like my doctors! It's mindboggling to me, and it cheapens the profession, I think.
I'm a pharmacist and I see this in hospitals and doctor offices all over.
Those drugs that the docs take for free are then passed out to patients who don't have insurance but need that $100 antibiotic. Or allow a patient to try a sleep aid without paying their $25 copay for just 5 tablets. Or get a patient started on a medication and titrated to their dose without needing to fill 4 different scripts for 3 days apiece.
I've seen plenty of medical professionals use that free pen to write a prescription for the competitor. Lunch is used to get everyone to sit down and learn about the drug. Otherwise, no one has time to sit.
I changed doctors because my doctor cared more about drug reps than about me. When I have an appointment, and the drug reps breeze in and are welcomed back while I sit and cool my heels with old magazines, I know who is more important. The message was clear! I advised the office staff I wanted my records as soon as possible so I could switch to a physician who would put patients first. See the drug reps before or after office hours, or over a sandwich in your office......but don't keep patients waiting. Or take up an appointment slot for a drug rep.
And physicians shouldn't complain about politicians who take gifts, including trips, from lobbyists, if they accept gifts, expensive meals, and trips or trip subsidies from the drug reps who are lobbying them.
And to the pharmacist who left a message on 4/26: those drugs aren't free! The cost for the drugs, the drug reps, the gifts, the meals, the trips, and the trip (continuing ed) subsidies are calculated into the cost of every drug sold. There's no such thing as a free lunch!
Jeffrey, I was surprised at reading a couple of posts about this ethics problem that were pretty mean spirited. My background in medical insurance underwriting, which involved working closely with physicians and my own experience in dealing with physicians personally when being treated for my own relatively minor ills and knowing generally how physicians deal with drug samples leads me to believe that anyone who complains about physicians and free samples are just a bunch of spoiled children. Of course, someone had to throw in about the cost of free samples entering into the cost of the drugs. Yes, we call that the cost of doing business! And another poster was put out he had to wait while a physician saw a salesman before taking such an important person as him! I believe the problem is complicated by the fact that where once we honored and revered physicians generally, where now people have no more respect in dealing with physicians than they do a car mechanic. In the old days, no one would have questioned the right of physicians to dispense the complimentary drugs in a way he or she saw fit. I myself have benefited from such largesse, because I don't have drug coverage and a physician gave me drugs for a foot problem that would have cost me at least $500 if I purchased them alone. Some people just seem to have time to complain about anything that in truth they have no knowledge about. We've got a system of hundreds of drugs now in use and more coming out every day. The doctors rely on salesmen to keep them informed about uses and side effects and everyone should be satisfied to let physicians use their own judgement on the use of these complimentary drugs. Maybe the complainers would like to have Hillary Care and see how they like waiting months for simple procedures - it's coming and they're worried about free drugs!
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