Gift bans may be all the rage on the federal and local level, but they’re not seen as a dire necessity among physicians, according to a survey of nearly 600 doctors.
The anonymous study revealed that 72.2 percent of the doctors surveyed believe industry-sponsored meals and other "small gifts related to clinical practice" are appropriate and a quarter consider large gifts appropriate. Although gifts as significant as vacations were perceived as acceptable by only 10.3 percent of the surveyed docs, gifts such as textbooks received a 83.2 percent favorability rating.
The researchers, Drs. Deborah Korenstein, Salomeh Keyhani and Joseph Ross, conducted the study between June 1 and Sept. 1, 2008, at hospitals in the Mount Sinai School of Medicine consortium in the New York metropolitan area.
The study, published in the Archives of Surgery, was designed to explore the attitudes of physicians across all specialties toward the medical device and pharmaceutical industries. Surgeons surveyed held the highest opinions of gifts and payments with, notably, 75.8 percent approving of industry-funded residency programs, versus 60.8 percent of other respondents. More than 83 percent of respondents approved of meals. Pediatricians surveyed held the lowest opinions of gift-giving, with 47.2 percent approving of funded residencies and almost 80 percent disapproving of meals.
Non-attending physicians and trainees held higher opinions on gifting, indicating that doctors’ level of training is related to attitudes towards the industry. Three-quarters of non-attending physicians viewed gifts and lunches positively, versus 61.1 percent of attending physicians. A quarter of non-attending doctors thought trainees should be banned from interactions with industry representatives; about half of attending docs surveyed thought such practices should be banned. According to the report, 78.9 percent of trainees approved of a variety of industry gifts, such as meals in clinical settings, versus 60.9 percent of attending doctors. Almost 90 percent approved of receiving textbooks from industry reps.
Fifty-four percent of those surveyed were familiar with their institution’s policy toward interactions with the industry, and 52.8 percent of docs who were familiar with the guidelines thought free samples did not improve patient care, compared to 65.5 percent of those who were not familiar with their institutions’ policies.
States including Massachusetts, Vermont and Minnesota and even the federal government have enacted rules governing gifts and payments to physicians by the medical device and pharmaceutical industries. However, an omnibus economic development bill is currently circulating through Massachusetts’ legislature that would kill the Commonwealth’s ban. Though the bill’s chance of passage is slim, due to the ban’s popularity, industry advocates say it increases expenses for medical device makers and pharma companies and squelches innovation. Some doctors complain that it also restricts their opportunity to receive training on the use of new devices. And restauranteurs in Massachusetts are seeking an exemption from the ban via an amendment to the omnibus economic development bill.