Most physicians think free lunches, small gifts OK

Physicians of all specialties, but especially surgeons, continue to see gifts from the pharmaceutical and device industries in a positive light, according to a recent survey.

Almost 600 physicians and medical students in the Mount Sinai School of Medicine consortium were asked about their attitudes toward industry interaction. A majority of the respondents favored the use of samples as well as industry sponsorship of lunches, educational materials and medical school and residency programs. More than half also thought it was acceptable to receive dinner at a modest restaurant if an educational component was included and to have industry pay for travel expenses to a conference.

Just less than half of the survey participants found it appropriate to accept a small gift (less than $50) from a company, and only a quarter thought it was OK to take a larger gift. The surveyed physicians also thought that they personally were less likely to be affected by free food or gifts than their colleagues: Only about 35% said it would affect their prescribing, while 52% said their colleagues would be influenced. The study was published in the June Archives of Surgery.

Surgeons, trainees and respondents who weren't familiar with their own institution's guidelines on the subject were more likely to have a positive attitude toward pharma interactions and gifts. This may be because less attention has been paid to this issue by surgical journals and societies, according to the study authors. A critique that accompanied the article also noted the importance of distinguishing between types of interactions with industry; development of new surgical techniques requires collaboration between clinicians and device makers, but the benefit of a free pen or sandwich does not outweigh the risk of influence, the critique said.

Based on the survey's results, one can conclude that physicians generally may be out of synch with public thinking about industry interactions, the study authors said. Despite changes in medical school policies and governmental concern about the issue, physician attitudes are similar to those found in studies going back to 2001. Physician attitudes are not likely to change until the entire culture of medicine rejects industry influences more thoroughly, the authors concluded.