Doctor freebies common, study says

Family practice physicians, who prescribe a broad range of drugs, were more likely to receive visits and gifts from sales reps than other specialist groups involved in the survey, researchers said.

Doctors in group practices were likelier to pocket fees for consulting or lectures than physicians at hospitals and clinics, which tend to have rules limiting contacts between the medical staff and industry, according to the report.

The study of 1,662 doctors, conducted in 2003 and 2004, is the first to look at physicianindustry relationships since the American Medical Assn. and drug industry each set voluntary limits on the nature and value of gifts doctors may receive in 2002.

The guidelines were prompted by increasing concerns over possible conflicts of interest related to handouts and freebies from drug companies.

Recently, a few academic medical centers, including Stanford University's, have prohibited all gifts, concerned that even the smallest token could create a sense of obligation on the part of the physician.

Lead author Eric Campbell, assistant professor of medicine at the Institute for Health Policy at Massachusetts General Hospital, said he was surprised to find that the relationships between physicians and industry were so widespread.

Campbell said the study was not designed to assess whether the relationships influenced doctors' prescribing habits or affected patient care. Nonetheless, he said that it was clear many doctors benefited directly from the industry's marketing tactics and that it was safe to assume drug companies also benefited.

The industry spends more than $20 billion a year on marketing, he said, the bulk of which goes to physicians in the form of samples, lunches, sponsorship of educational programs and other things, according to previous research.

"If the companies didn't benefit from the relationships, they wouldn't be doing it," he said.

AMA guidelines state gifts should primarily benefit patients and should not be of substantial value. The Pharmaceutical Research and Manufacturers of America, or PhRMA, the drug industry trade organization, recommends gifts that support a medical practice, such as a stethoscope, and do not exceed $100 in value.