A survey released on Wednesday revealed that nine out of 10 US doctors have some kind of a relationship with the drug industry, by either accepting gifts, such as food, beverage, free drug samples, or by taking money for lectures or signing up patients for trials.

The researchers said that, although this relationship between doctors and drug makers might help pharmaceutical companies develop better, more efficient products, the benefit for patients isn’t always clear.

“To what extent do patients benefit if doctors receive money for giving talks at conferences?” asked Eric Campbell, the lead researcher and an associate professor of medicine at Massachusetts General Hospital and Harvard Medical School in Boston. “There is no data to address that.”

“We know that these relationships have benefits and risks, and we know that they benefit the companies that are involved, and we know from our data that they benefit doctors. The real question is what effect these relationships have on the quality of patient care. The fact is, we don't know if doctors who have these relationships practice better medicine than doctors who don't,” Campbell said.

The study of 1,662 physicians in six specialties (anesthesiology, cardiology, family practice, general surgery, internal medicine and pediatrics) found that 94 percent “reported some type of relationship with the pharmaceutical industry,” with more than 83 percent receiving food in the workplace and 78 percent receiving free samples. Also, 34 percent reported payments for meetings or for continuing studies, while 28 percent received payment for consulting, giving lectures and enrolling patients for trials. Some 7 percent of doctors said they received tickets to cultural or sporting events.

The survey revealed that the doctors most likely to receive industry payments were the least likely to be caring for the poor. For example, heart specialists were twice as likely as family practitioners to get direct payments from drug companies, although family doctors met more frequently with drug makers than cardiologists. Female doctors were less likely to receive payments than males.

The more influential the doctor, the greater the chance to receive benefits from pharmaceutical companies. “It appears pretty clear that industry forms tighter relationships with doctors who are really the thought leaders, the ones who are likely to affect the behavior of other doctors,” said David Blumenthal, director of the Institute for Health Policy at Massachusetts General, quoted by Bloomberg.

On average, physicians meet with industry representatives four times a month, and medical residents accept six gifts annually from industry representatives.

“We need to look for things like whether doctors who have a relationship with a company are more likely to prescribe drugs made by the company, or brand names rather than generics,” he said. “That's the next step, and, until we get there, we're just not going to know.”

The Survey was published in this week's issue of the New England Journal of Medicine.
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