American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Physican-Industry Relations


In 2008, pharmaceutical companies and medical device makers spent more than 2 billion dollars marketing their products to the medical community. But are accusations of conflict of interest overblown? Is industry money necessary for continued medical progress and innovation? Or should we ask ourselves, like some critics of physician-industry relations do, why these companies waste their money if no physicians are influenced?

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A doctor is busy seeing patients, but he accepts a visit from a pharmaceutical representative. In exchange for spending some time with the rep who's there to share some information about a new drug, the doctor accepts a textbook with information related to his specialty.

A surgeon gets an invitation to hear a talk about a new surgical procedure. The talk will take place at a local steak house, and the surgeon is encouraged to bring his wife along.

Is there anything wrong with either of these very common interactions between physicians and members of the pharmaceutical and medical device industries? Is there any reason to suspect that doctors and surgeons are susceptible to the influence of these industries when gifts are exchanged for their time and attention?

Critics of physician-industry relations point to cases of apparent conflicts of interest like a recent report by Mayo Clinic researchers about doctors who defended Glaxo-Smith-Kline's troubled diabetes drug Avandia. A May 2007 study showed that Avandia significantly increased the risk of heart attacks. The Mayo Clinic report found that nearly half of the physicians who defended the drug in scientific studies had financial ties that presented a conflict of interest, with 94 percent having some tie to drug companies.

In 2008, the medical industry spent more than two billion dollars marketing their products to physicians and members of the medical community. But is this relationship inevitable and essential given physicians need to stay up to date on the latest innovations in medicine and surgery, and is concern about industry influence, despite examples like the Avandia study and others, unfounded?

Dr. Tom Stossel is the director of the translational medicine division at Brigham and Women's Hospital at Harvard Medical School and a senior fellow at the Manhattan Institute for Policy Research. Dr. Stossel is a vocal advocate for preserving the relationship between physicians and the pharmaceutical and medical device industries.

Dr. Howard Brody is a director at the institute for medical humanities and a professor of family medicine at University of Texas Medical Branch in Galveston. Dr. Brody is the author of "Hooked: Ethics, Medicine and Pharma," a critical look at the relationship between physicians and the pharmaceutical industry. He wants a clear divide between members of the medical community and the medical industry.