Studies say physicians are being influenced by drug companies and others
Studies say physicians are being influenced drug
By STEVEN G. GABBE, M.D. • February 18, 2008
At 8 a.m. on Aug. 8, 2007, during their very first week of medical school, Vanderbilt medical students heard a lecture from Dr. Ellen Wright Clayton, professor of law and pediatrics, about potential conflicts of interest faced by practicing physicians, including those related to pharmaceutical and medical device companies.As the students left the lecture hall, they passed by tables of bagels, juice and coffee set up for another lecture next door where the audience of faculty physicians and residents listened to a noted expert on heart disease review the latest research on a new treatment.
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These types of lectures, commonly known as grand rounds, represent a tradition of how physicians at academic medical centers like Vanderbilt stay up to date on the very latest medical discoveries and their application to patient care.
However, students noticed that, at the end of the breakfast table was a display of pens, notepads and pamphlets all prominently bearing the name of a new and highly effective drug brought to the market by a pharmaceutical company whose representative was sitting behind this table.
During their first week of medical school, these students faced their very first professional dilemma: Does the presence of marketing materials and the offer of a free meal by a pharmaceutical company representative create a potential conflict of interest for physicians in the care of their patients because they may be more likely to prescribe a specific drug as a result of this exposure?
Prescribing behavior is affected
Many physicians believe their level of professionalism and integrity would not allow such a small token to influence their medical judgment. Recent studies, however, have shown that the prescribing behavior of physicians may be more highly influenced by meals and gifts than physicians often realize. These studies are consistent with years of marketing research that show how all of us are affected by product advertising.
That’s why many medical centers, including Vanderbilt, have for years had some level of restriction on the value of gifts and meals that companies could provide physicians and employees.
However, as recently reported in The Tennessean, Vanderbilt University Medical Center has joined a growing number of academic medical centers across the country by establishing a policy that no physician, staff member or trainee shall accept a personal gift or meal from an industry representative regardless of the value of the gift. This new policy is based upon the understanding that physicians and other health-care providers have a special obligation to their patients to make medical decisions based solely upon the best scientific evidence available.
These decisions should not be compromised by even the slightest appearance of any conflict by industry marketing practices. If we are going to teach medical students, beginning in their first week of medical school, about their obligations as a professional, we must make sure their teachers are modeling the behavior we are teaching. It’s the right thing to do for our students and our patients.
Steven G. Gabbe, M.D. is dean of the Vanderbilt University School of Medicine.