BOSTON (Reuters) - Virtually all U.S. doctors take freebies from drug companies, and a third take money for lecturing, signing patients up for trials or going to meetings, according to a survey published on Wednesday.
The study of 1,662 physicians found that 94 percent "reported some type of relationship with the pharmaceutical industry," with more than 83 percent receiving food in the workplace and 78 percent receiving free samples.
More than a third admitted getting payments from the drug companies for giving lectures, signing up patients for drug testing, or going to medical meetings.
And the more influential a doctor was, the greater the likelihood that he or she would be benefiting from a drug company's largess, the researchers report in this week's issue of the New England Journal of Medicine.
Dr. Eric Campbell of Massachusetts General Hospital and Harvard Medical School said patients may not want to know their doctor was being influenced in this way.
He likened it to a baseball umpire getting meals from a team owner.
"We assume that the guy who's umping the Red Sox game doesn't get frequent lunches from the owners of the Red Sox, and those owners don't pay for them to go to exotic places and have seminars on how to call games," Campbell said in a telephone interview.
Only about half the doctors sent questionnaires responded to the survey, even after being sent $20 for their time.
The issue of drug company influence has been debated for decades. Also this week, two studies in the Public Library of Science journal PLoS Medicine demonstrated that standard sales techniques used by sales representatives influenced the drugs that doctors chose to prescribe.
The new study is the first to gauge the extent of the relationships since the drug industry lobby group Pharmaceutical Research and Manufacturers of America adopted a new code of conduct in 2002 designed to limit gifts and ensure that interactions between doctors and drug company representatives benefited patients.
The Campbell team found that the number of meetings between doctors and industry representatives has actually increased since a study in 2000.
But in many cases, the researchers found, there was little apparent benefit to patients.
Four out of five doctors reported getting gifts of food or beverages in the workplace.
"The real question is what effect these relationships have on the quality of patient care. The fact is, we don't know if doctors who have these relationships practice better medicine than doctors who don't," Campbell said.
"We know anecdotally that they're likely to increase the costs, potentially tremendously."
The doctors most likely to receive industry payments were the least likely to be caring for the poor.
While family doctors received more visits than physicians in other specialties, heart specialists were twice as likely as family practitioners to get direct payments from drug companies, Campbell's team found.
Doctors who trained other doctors were also more likely to receive drug company payments.
"It appears pretty clear that industry forms tighter relationships with doctors who are really the thought leaders, the ones who are likely to affect the behavior of other doctors," said coauthor David Blumenthal of the Institute for Health Policy at Massachusetts General Hospital.
Female doctors were less likely to receive payments than males.
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