Study: Attitudes over doctor-industry ties not as evolved as we think

Despite the negative attention recently cast on physician-industry ties, a new study by researchers at Mount Sinai School of Medicine reveals that most individual physicians are still welcoming of gifts and royalties from drug and device makers.

Of the 590 doctors and medical students who responded to a survey, 72.2 percent said that industry-sponsored lunches were appropriate. However, 74.6 percent said large gifts were unacceptable. Respondents also believed that other doctors--not them--were more likely to be influenced by gifts and food from industry. Results varied by specialty, with surgeons and medical students more likely to accept hotel and travel expenses for attending lectures, while more pediatricians balked at gifts.

The study, published in the June issue of the Archives of Surgery, concluded the following: "Our overall finding of favorable physician attitudes toward industry suggests that individual physicians may be out of sync with trends among medical schools and public opinion and even industry itself. Although the evidence that physician-industry marketing relationships result in patient harm is inconclusive, U.S. medical schools have increasingly adopted restrictive policies toward industry interactions, and there is widespread public concern that financial relationships between physicians and industry lead to conflicts of interest."

Some work is being done to change attitudes at the medical-school level. As the New York Times reported yesterday, the University of Michigan Medical School has become the first to decide that it will no longer take any money from drug and device makers to pay for coursework doctors need to renew their medical licenses. The funds in question currently amount to about $1 million a year at the school, while nationwide, commercial payments for industry speakers and courses come to about $1 billion--nearly half the total expenditure for such courses.

The decision to turn away the money drew criticism from some doctors, including the director of the National Institutes of Health and the president of the American Heart Association, who said it would unfairly cut physicians off from scientific knowledge, according to the newspaper. Conversely, Dr. Bernard Lo, lead author of a 2008 Institute of Medicine report on conflicts of interest, said private doctors and academic physicians who are paid to speak for drug companies should be barred from presenting educational material at accredited conferences.

Although these issues have been debated here for some time, drug maker gifts and samples are recently coming under scrutiny abroad as well. In the European Union, where most medicines are paid for by governments or insurers as a form of marketing, drug makers have pledged to cut back on handing out free medicines to doctors across, reports the Financial Times. Going forward, member companies will limit "sampling" or giving free medicines to doctors to four packets per doctor, and for no longer than two years after the launch of a new drug.

Andrew Witty, chief executive of GlaxoSmithKline who recently took over as president of Efpia, said: "Our industry needs to be in touch with society's expectations and with peoples' appropriate demands for both greater transparency and for a greater commitment to high ethical standards....We believe that full adherence to these codes is essential, and that breaches should not be tolerated."

To learn more:
- read this article in the New York Times
- see this piece in the Los Angeles Times
- check out the article from Businessweek/HealthDay News
- here's the study abstract in the Archives of Surgery
- see this story in the Financial Times (reg. required)