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Many Docs Don't Mind Taking Gifts From Industry: Study

Most don't think they're influenced by corporate marketing

MONDAY, June 21 (HealthDay News) -- Although the landscape is changing, many doctors do not have a problem with taking gifts or participating in corporate marketing, a new study shows.

This includes gifts, free samples from drug companies and collaboration with hardware manufacturers to help develop new devices, as well as accepting meals and travel expenses, the researchers added.

"We found small but significant different attitudes across specialties in attitudes towards industry," said lead researcher Dr. Deborah Korenstein, an associate professor of medicine at Mount Sinai School of Medicine in New York City.

"Independent of these small differences, we found physicians tend to continue to have very positive attitudes in spite of increasingly negative attitudes towards these interactions on the part of government and the public," she said.

For doctors, this is a tricky area, Korenstein said. "Particularly in regard to surgeons, who have very collaborative relationships with industry," she said.

The report is published in the June issue of the Archives of Surgery.

For the study, Korenstein's team surveyed doctors and trainees in 11 hospitals participating in the Mount Sinai School of Medicine consortium.

Of the 590 doctors and medical students who responded, their attitudes toward industry were mostly positive, the researchers found.

In fact, 72.2 percent said that industry-sponsored lunches were appropriate. However, 74.6 percent said large gifts were unacceptable. They also believed that other doctors, not them, were more likely to be influenced by gifts and food from industry.

"But people don't recognize the extent to which they may be influenced," Korenstein said.

Among those queried, surgeons and medical students had more positive attitudes toward industry than others. They were also more likely to accept some gifts, such as hotel and travel expenses for attending lectures.

Among all doctors, pediatricians had less favorable attitudes toward industry, while non-attending doctors were more positive about receiving meals, textbooks and medication samples, the study authors noted.

Mount Sinai School of Medicine consortium has a policy that bans or limits marketing-related interactions between physicians and industry, Korenstein pointed out.

Yet, only 54.2 percent of the doctors were familiar with the policy. Those unfamiliar with the policy were more positive about such interactions, the researchers found.

Korenstein said that most such policies ban the payment of gifts, meals and travel expenses, even seemingly benign gifts such as logo pens and pads, she said. "I do think they are potentially influential," she noted.

"In addition, there is evidence showing that patients perceive that their physicians are influenced by even small things like pens and mugs," Korenstein explained.

But in some areas of medicine there is no clear line between when a relationship is collaborative and when it is marketing, Korenstein said.

"The harder things for surgeons are things like the development of new devices, because it involves collaboration with the company -- and I don't have an answer where to draw the line there," she said. "Those are the much more challenging issues."

Moreover, while most patients don't seem to mind getting medication samples from their doctor, "there is evidence that samples are influential in the way doctors practice," Korenstein stated.

The bottom line for Korenstein is that doctors need to become more aware of these potential conflicts of interest.

"Physicians need to continue to take action, so that attitudes can catch up with the attitudes of the rest of the country in terms of the government and the public. Increasingly, physicians' organizations recognize this and are doing what they need to do to educate physicians and to change attitudes. But because it involves a real shift in the culture of medicine, it is a bit of a slow process," she said.

Dr. Jorge Guerra, associate vice chair for medical affairs at the University of Miami Miller School of Medicine, said these findings were made in 2008 and since then the pressure for doctors to not have any conflict of interest has heated up even more.

"If you ask me whether I am influenced, I will tell you I am not, but if you ask me whether my peers are influenced I will tell you they are," Guerra said. "We think the rest of us are corrupt, but we don't think we are."

However, Guerra thinks collaboration between medicine and industry is particularly important in developing new medical devices. But that relationship needs to be transparent to both the medical community and the public at large.

"If I can't deal with industry to help them develop new devices, new devices won't come to market," he said. "It isn't stopping the relationship that is important, it's revealing the conflicts and being very clear about them."

More information

For more information on doctors and conflict-of-interest policies, visit the U.S. National Institutes of Health.

SOURCES: Deborah Korenstein, M.D., associate professor, medicine, Mount Sinai School of Medicine, New York City; Jorge Guerra, M.D., associate vice chair, medical affairs, University of Miami Miller School of Medicine; June 2010, Archives of Surgery

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