The pharmaceutical industry interacts with the medical profession by supporting clinical research and assisting in medical education activities in academic medical centers. Medical students and residents spend years establishing patterns of prescribing and making relationships with pharmaceutical companies. The pharmaceutical industry has a significant presence during residency training, gaining the overall acceptance of trainees, and appears to influence prescribing behavior. Contact with pharmaceutical representatives is common among medical students and residents. Residents acknowledge the potential for industry influence in others, but generally not in themselves, despite evidence that they themselves are influenced as well. The prescriptions written by residents are associated with pharmaceutical representative visits and the availability of samples. A variety of policy and educational guidelines appear to influence residents’ attitudes toward interactions with industry representatives, although data on the long-term effects of these interventions are limited. This article contends that medical training programs can benefit from policies and curricula that teach medical students and residents about the influence of marketing and how to critically evaluate the information they receive from industry representatives.

In 2017, the Korean Medical Association (KMA) revised its Code of Ethics at the request of the Korean Society for Medical Education. Through this revised Code, which incorporates the concept of medical professionalism, the KMA hopes to strengthen and improve its self-regulatory powers. This article examines different aspects of self-regulation and explores the connection between self-regulation and medical professionalism. Using the examples of maintenance of competency and the management of conflict of interests, it is argued that medical professionalism is the goal of self-regulation. Additionally, since medical professionalism cannot be implemented through the efforts of individual doctors or even medical institutions without broader social support, it is suggested that society as a whole should be fully informed of the importance of self-regulation and medical professionalism.

Overtreatment (or unnecessary treatment) occurs when medical services are provided with a higher volume or cost than is appropriate. Of course, practicing good medicine and avoiding unnecessary harm have always been principles of medical practice. Currently there is a new emphasis on reducing practices that are likely to have limited benefit or that involve potential harm. Waste due to overtreatment has been described as a violation of the principle of justice on the assumption that every system has limited resources and any wasted resource necessarily means those resources will no longer be available for use by others in need. Overtreatment may also cause direct harm to patients, thus violating the principle of non-maleficence. Physicians are rarely motivated by the desire to achieve system efficiency or to save money for its own sake. However, it is widely understood that physicians should be motivated by a desire to do the right thing in terms of promoting the patient’s best interest. And doing the right thing includes an ethical imperative to provide parsimonious care. Recognizing this fact helps to bridge the enormous quality chasm that still exists between the medical care that is currently provided and the medical care that should be provided. The purpose of this study is to identify and assess the factors that cause overtreatment (unnecessary treatment) in the Korean medical system and to suggest certain solutions to this problem.

As information provided in pharmaceutical marketing brochures has the potential to change doctors’prescribing behavior, ongoing efforts to increase awareness about drug promotion are crucial. However medical information in journal advertising has been criticized in several studies for being of poor quality. To find out the accuracy and ethical status of pharmaceutical marketing brochures about proton pump inhibitors prescribed in one university hospital in South Korea, six brochures were collected from pharmaceutical representatives visiting the family medicine out-patient department of that hospital between May 2010 to March 2011. We examined these brochures for the types of claims that were made, the amount and type of evidence provided, the authenticity of the quoted references, and whether or not the brochures satisfied the “World Health Organization (WHO) criteria 1988.” We also ascertained the source of funding for the original research cited in the brochures. Upon analysis, none of the promotional brochures fulfilled all of the WHO criteria. All brochures used emotionally loaded language and made exaggerated claims about the efficacy of the medicine in question. A total of 61 references were found in these brochures, 86.8% of which were journal articles. Of the journal articles cited in these brochures, 73.6% were SCI level, most were based on randomized controlled trials (RCT, 53.8%), and 41.5% were sponsored by pharmaceutical companies. Additionally, 17.1% of the claims made in these brochures were incorrect according to the published articles cited in the brochures, and 10.4% contained vague descriptions. We conclude that some of the information provided in pharmaceutical brochures for physicians is incorrect. Accordingly, we suggest that physicians need to be cautious about the reliability of information provided in drug advertisements and should follow the principles of evidencebased medicine in assessing the validity of information provided by pharmaceutical companies.