A recent article in MedPage Today reported that most physicians have a favorable view about gifts from pharmaceutical and medical technology companies.' What do we, as patients or potential patients, think about that?
Well, it's hard to form an opinion when we don't know everything that is going on between doctors and companies.' An article published in 2009 in the International Journal of Health Services found that our awareness that our doctors receive gifts, varies, depending on what kind of gift it is. For example, 94 percent of us know about free drug samples but only 19 percent of us have heard about golf tournament fees being reimbursed by companies.
So how do we feel once we are informed of this gift giving practice? Only four percent of us approved of reimbursed golf tournament fees and 12 percent of us approved of physicians receiving dinner from pharmaceutical companies.' Around half of us approved of drug samples, pens, and medical books as gifts.
When I see a pen in my doctor's hand with a drug company logo on the side as she writes my prescription, I wonder what other interactions between her and the drug company rep occur. I am concerned with how these interactions influence the medication she prescribes and the cost of that medication. Further, I know that this relationship between the pharmaceutical company and potentially other medical technology companies does not stop with a pen.' Companies spend $25 billion each year marketing to doctors.
This problem hasn't gone unnoticed. The Physician Payment Sunshine Act within the health care reform bill requires drug and medical device manufacturers to publically report payments made to physicians and teaching hospitals. Payments include cash compensation, food, entertainment, travel expenses, consulting fees, honoraria, research funding or grants, education or conference funding, stock or stock options, ownership or investment interest, royalties or licenses, and charity contributions. Physicians' names, address, value, date, and form of the payment will be available for the public in an online database starting by September 30, 2013.
I think this is a step in the right direction, but I fear it won't really benefit us. Is the expectation that we will now conduct research on possible conflicts of interest of our doctors prior to each visit?
And having done so, what will we do with this information? Should we not consult a physician on the grounds that he or she has received gifts from many drug companies? Personally, I'd feel intimidated to initiate this conversation with my doctors and fear it would erode our relationship.
From our perspective, it looks like the doctors get all the pens and the free lunches, while we get to do all the research and risk our relationship if we raise questions. It turns out that the Sunshine Act isn't so bright after all.
How do you feel about gifts given to your doctor from drug and medical device companies?