Physician Perks, Potential Patient Hurts
The Journal of the American Medical Association reports that physicians are increasingly being influenced by drug manufacturers and medical device makers to promote specific products to their patients. This influence creates a conflict of interest between the physician’s duty to the patient and the physician’s perceived obligations to the drug manufacturers and device makers.
Drug manufacturers and device makers promote their products by sending field representatives to physicians. They usually offer lunches, freebies, such as pens, pads, and drug samples, as well as bigger perks such as organizing meetings for which physicians are paid for their time to attend, paying for participation in speakers bureaus, paying for consulting, or offering grants for research. The list of creative ways to provide incentives goes on and on.
While the influence of some of the bigger gifts seems obvious, there is a myth that a small gift, such as a free pen, creates no influence. However, as the Journal reports, studies have found there is a basic human feeling of reciprocity that physicians also fall prey to which could negatively impact clinical decisions. What is even more worrisome is that patients who receive medical advice based on this bias have no way of knowing about it.
The Journal makes key recommendations for resolving this conflict of interest:
- Banning all gifts
- Banning Pharmaceutical Samples
- Creating new guidelines for drug formularies & device procurement committees
- Creating a central repository to finance continuing medical education
- Creating a central repository to finance travel to conferences and symposia
- Banning paid physician positions on speakers bureaus and ghostwritten articles for faculty at academic medical centers
- Banning general consultation and research support
- Outlining specific guidelines regarding contracts and deliverables