Under the microscope...doctors' relationships with drug companies

According to a recent survey almost all doctors in the U.S. have some form of relationship with drug companies.

In the first national survey to examine the extent of relationships between industry and practicing physicians, it was found that 94 percent of doctors admit they have at least one type of relationship with the drug industry.

The survey also found that family doctors were the ones most likely to meet with industry sales representatives, while cardiologists were more likely to pocket fees than other specialists.

It was found that doctors in private practice were six times more likely to get free samples and three times more likely to receive gifts than those at hospitals while female doctors were less likely to receive payment than their male counterparts.

Most doctors surveyed said they received some form of kickback in the form of food in the workplace or prescription samples.

It was found that four out of every five doctors surveyed allowed drug and device makers to buy them food and drinks, this is despite a leading industry group in 2002 adopting voluntary guidelines discouraging companies from giving doctors any form of gifts, aimed at tightening the ethics rules in order to avoid conflicts of interest.

The researchers found that little had in fact changed since 2002 and consumer advocates say this proves the new rules are not working.

The Center for Science in the Public Interest says the findings are disturbing.

For the study the researchers posted questionnaires to 3,167 doctors around the U.S. in 2003 and 2004.

In total 1,662 replied including anesthesiologists, cardiologists, family doctors, surgeons, internists and pediatricians.

They ranged in experience from less than 10 years to over 30 years, half were in private group practices and the rest worked in hospitals and medical schools and all the responses were anonymous.

Concern about physician-industry relationships, has prompted a number of groups such as the Pharmaceutical Research and Manufacturers of America, the American Medical Association and the American College of Physicians to institute codes of conduct that set limits on gifts to physicians from industry.

PhRMA recommends that gifts not exceed $100 in value and should be only items that support a medical practice such as a stethoscope while the AMA recommends that any gifts accepted by a physician should primarily entail a benefit to patients and not be of substantial value.

Lead researcher and co-author Eric Campbell, Ph.D., an associate professor of medicine at the Institute for Health Policy at Massachusetts General Hospital and Harvard Medical School, says the relationships appear to benefit both the doctors and industry but the question is whether these relationships benefit patients in the terms of the care they receive.

The study was funded by a grant from the New York-based Institute on Medicine as a Profession (IMAP) who are particularly concerned about doctor-industry relationships and conducted by researchers from Massachusetts General Hospital, Yale University and the University of Melbourne in Australia.

It is published in the current issue of the New England Journal of Medicine.