Changing Interactions Between Physician Trainees and the Pharmaceutical Industry: A National Survey

Abstract

Despite recent policy changes, a substantial number of trainees continue to receive gifts from pharmaceutical representatives. We found no relation between these outcomes and a school's policies concerning interactions with industry.

Orthopaedic Surgeons Receive the Most Industry Payments to Physicians but Large Disparities are Seen in Sunshine Act Data

“…Although orthopaedic surgeons maintain strong ties with device manufacturers owing to the need for physician input in the development of new and innovative surgical devices, previous analyses of the Sunshine act data revealed a large difference between the field and others. While previous research has shown that industry payments may affect provider practices [3,4,10,18,21,30,40] and patient perceptions of their physicians [32,48], our study showed that substantial disparities in payments do exist among orthopaedic surgeons and that the median orthopaedic surgeon does not receive a large sum. The majority of total payments to orthopaedic surgeons are for royalties and licenses for intellectual property, which actually foster device innovations and are viewed more positively by patients and physicians [8].…”

Physician Trainees’ Interactions with the Pharmaceutical Industry

“…T he Authors' Reply-The differences Ramachandran et al note between our results 1 and two other recent publications 2,3 may be explained by both the analytic approaches used in our different studies and the outcomes we examined. In their important papers, both King et al and Epstein et al analyzed prescribing patterns for psychoactive drugs, using difference-in-differences models that dichotomized medical schools or residency training programs based on their conflict of interest policies alone, and found that those policies were important predictors of subsequent actual drug prescribing decisions.…”

Medical Schools' Industry Interaction Policies Not Associated With Trainees' Self-Reported Behavior as Residents: Results of a National Survey

“…Organizations, such as the Institute on Medicine as a Profession (IMAP) and the American Medical Student Association (AMSA), have conducted systematic evaluations of the strength of academic institutions' industry interaction policies in an effort to improve the regulation of industry interactions, with a particular focus on the effect on medical trainees. Previous studies 1,17 have demonstrated that students at medical schools with more restrictive policies were less likely to accept gifts and interact with the pharmaceutical sales representatives than those at schools with less restrictive policies. Since medical schools are the starting points of physicians' professional development, we used national survey data to identify whether behaviors and attitudes related to industry interactions persist into the residency period.…”

“…1,2 To varying degrees, these interactions may create a sense of obligation to use promoted products, reducing evidence-based prescribing, with physicians not always aware of the influence of biased information. [3][4][5][6][7][8][9][10][11] Previous studies [12][13][14][15][16] have suggested varying effects on prescribing behavior and attitudes toward the pharmaceutical industry among medical students and residents.…”