Gifts to Physicians From Industry: The Debate Evolves

Moskop, John C.; Iserson, Kenneth V.; Aswegan, Andrew L.; Larkin, Gregory Luke; Schears, Raquel M.

doi:10.1016/j.annemergmed.2011.08.001

Cited by 12 publications

(7 citation statements)

References 42 publications

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“…Individual EPs often receive small, inexpensive gifts and feel indebted, which may induce them to use or advocate for specific products when they otherwise would not. Social science research suggests that even trivial gifts may produce a psychological debt . This is an example of potential COI, which may be subconscious.…”

Section: Cois In the Practice Of Emergency Medicinementioning

confidence: 99%

Conflicts of Interest in Emergency Medicine

Geiderman

Iserson

Marco

et al. 2017

Academic Emergency Medicine

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Conflicts of interest (COIs) are common in the practice of emergency medicine and may be present in the areas of clinical practice, relations with industry, expert witness testimony, medical education, research, and organizations. A COI occurs when there is dissonance between a primary interest and another interest. The concept of professionalism in medicine places the patient as the primary interest in any interaction with a physician. We contend that patient welfare is the ultimate interest in the entire enterprise of medicine. Recognition and management of potential, real, and perceived COIs is essential to the ethical practice of emergency medicine. This paper discusses how to recognize, address, and manage them.

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Section: Cois In the Practice Of Emergency Medicinementioning

confidence: 99%

Conflicts of Interest in Emergency Medicine

Geiderman

Iserson

Marco

et al. 2017

Academic Emergency Medicine

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“…A few years ago, biomedical ethicist John Moskop and his colleagues neatly summed up the problem with the gifts given to medical professionals by medical and pharmaceutical industry representatives: “[G]ifts can afford drug reps an opportunity to provide information to physicians about their companies’ products. Inappropriate or inaccurate information, however, may result in drug use that is ineffective or harmful.” Following Moskop and others, we will take the following two assumptions for granted: first, that gifts influence physicians and, second, that the influences gifts have on physicians may be harmful for patients . These assumptions are common in the applied ethics literature, and they prompt an obvious practical question, namely, what is the best way to mitigate the negative effects?…”

Section: Articlementioning

confidence: 99%

“…Prior to the 1980s, it was generally assumed in the biomedical ethics literature that interaction between physicians and the medical industry was exclusively for the benefit of patients . Practitioners and theorists alike believed that the widespread practice of providing physicians and medical students with gifts such as office supplies, recreational items, medical instruments, drug samples, educational items, meals, and travel packages for “new‐dug symposia” did not influence physicians’ behavior .…”

Section: The Failure Of Policies Regarding Gifts In Medicinementioning

confidence: 99%

“…In a 2007 report, the American Association for Medical Colleges (AAMC) found “that industry support of medical education can indeed influence the objectivity and integrity of academic teaching, learning, research, and practice” and that this “is supported by the medical literature and by a growing body of neurobiological and psychosocial evidence related to the effects of gifts on recipients’ choices and decisions.” The studies in question typically show that physicians change their prescribing behavior after interaction with a drug rep: after the interaction, they are more likely to begin prescribing brand name medications rather than generics to uninsured patients . Physicians who accept drug samples are also more likely to view drug reps, whose interests lie primarily with their brand, as “valuable resources in learning about new drugs.”…”

Section: The Failure Of Policies Regarding Gifts In Medicinementioning

confidence: 99%

“…As Moskop et al. report, “[D]espite thse policies from major physician organizations, the pharmaceutical industry continued and expanded its gift giving practices” through the 1990s and 2000s . While in 1999 the medical industry spent around 8 billion dollars to send sales representatives to physicians and promote their products, in 2001 that investment had risen to 11 billion dollars, including “$8,000 to $13,000 spent directly or indirectly per year per practicing physician.”…”

Section: The Failure Of Policies Regarding Gifts In Medicinementioning

confidence: 99%

See 2 more Smart Citations

Implicit Cognition and Gifts: How Does social Psychology help Us Think Differently about Medical Practice?

Morar¹,

Washington²

2016

Hastings Center Report

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This article takes the following two assumptions for granted: first, that gifts influence physicians and, second, that the influences gifts have on physicians may be harmful for patients. These assumptions are common in the applied ethics literature, and they prompt an obvious practical question, namely, what is the best way to mitigate the negative effects? We examine the negative effects of gift giving in depth, considering how the influence occurs, and we assert that the ethical debate surrounding gift-giving practices must be reoriented. Our main claim is that the failure of recent policies addressing gift giving can be traced to a misunderstanding of what psychological mechanisms are most likely to underpin physicians' biased behavior as a result of interaction with the medical industry. The problem with gift giving is largely not a matter of malicious or consciously self-interested behavior, but of well-intentioned actions on the part of physicians that are nonetheless perniciously infected by the presence of the medical industry. Substantiating this claim will involve elaboration on two points. First, we will retrace the history of policies regarding gift giving between the medical profession and the medical industry and highlight how most policies assume a rationalistic view of moral agency. Reliance on this view of agency is best illustrated by past attempts to address gift giving in terms of conflicts of interest. Second, we will introduce and motivate an alternate view of moral agency emerging from recent literature in social psychology on implicit social cognition. We will show that proper consideration of implicit social cognition paints a picture of human psychology at odds with the rationalistic model assumed in discussions of COIs. With these two pieces on the table we will be able to show that, without fully appreciating the social-psychological mechanisms (both cognitive and affective) of implicit cognition, policy-makers are likely to overlook significant aspects of how gifts influence doctors.

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The Commercial Culture of Medicine

James

2016

The Health of Populations

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Gifts to Physicians From Industry: The Debate Evolves

Cited by 12 publications

References 42 publications

Conflicts of Interest in Emergency Medicine

Conflicts of Interest in Emergency Medicine

Implicit Cognition and Gifts: How Does social Psychology help Us Think Differently about Medical Practice?

The Commercial Culture of Medicine

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