A lot of scrutiny is being given this week to interactions beween industry and doctors, and the latest salvo comes from The New England Journal of Medicine, which today releases a study showing 94 percent of doctors reported some relationship with drug or device makers. This is despite efforts to reinforce ethics and eliminate conflicts of interest.

To be specific, 83 percent of the docs said they accepted free meals in the workplace; 7 percent took free tickets to sporting or cultural events; 35 percent accepted reimbursement for CMEs or meetings; 28 percent accepted payment for speaking, consulting, advisory board work or enrolling patients in clinical trials, and 78 percent took free samples.

The survey of 1,662 docs also found that family docs were more inclined to meet with sales reps (16 times a month, in fact), and that cardiologists were more likely to take fees than other docs queried. These included anesthesiologists, pediatricians, internists, family docs and surgeons. Docs in private practice, meanwhile, were six times more likely to get free samples and three times more likely to receive gifts than docs working in hospitals.

The study, which took place in 2003 and 2004, is the first to examine the relationships between docs and sales reps since 2002, when PhRMA adopted voluntary guidelines discouraging drugmakers from giving doctors freebies. The results suggest that not much has changed.

“The real issue is to what extent does the medical benefit outweigh the risk of these relationships,” says Eric Campbell, a co-author and assistant professor of medicine at the Institute for Health Policy at Massachusetts General Hospital and Harvard Medical School.

“And what we don’t know is whether the doctor who has these relationships practices medicine better than those who don’t. We just dont have the data. We do know that the company benefits and the doctor benefits. But does the patient? And in medicine today, by and large, we’ve decided to let the profession regulate itself.”

The study was funded by the Institute on Medicine as a Profession, or IMAP. None of the authors reported a conflict of interest.

Further reading…
The NEJM study (subscription may be required);
The IMAP web site.[tags]Conflicts Of Interest, Ethics, Sales Reps[/tags]