doctors like elected officials and government buerocrats can be bought - and the price isn't always that much :)

Group: Gifts guide doctors Makers of drugs influence patient treatment, it says

Bruce Japsen Chicago Tribune Jan. 25, 2006 12:00 AM

CHICAGO - Doctors continue to let gifts from drug and medical devicemakers influence the care they provide, according to a group of leading medical educators who urged physicians to stop accepting industry largesse.

Supporters of the reform said that disclosures by physicians have not worked and that self-policing has not gone far enough.

The recommendations, to be printed in today's Journal of the American Medical Association, mirror others that have shown gifts to physicians influence doctors' decisions on which drugs to prescribe. The gifts range from ball point pens to elaborate European vacations, World Series tickets and honorariums for speeches.

Employers and consumer groups say such gifts also lead to higher health care costs and put patients at risk when physicians choose more expensive brand name drugs or select an inappropriate treatment.

The authors urged the nation's academic medical centers to "exert tighter control" on drug and device companies. Drug companies alone spend "$13,000 a year per doctor on marketing activities, the costs of which are reflected in drug prices," the authors say.

"The data are overwhelming: gifts . . . affect which drugs doctors prescribe for their patients," said David Rothman, president of the Institute of Medicine as a Profession. "We are saying to academic medical centers, 'Clean up your act. If you don't, others will.' "

The Institute and the American Board of International Medicine Foundation, a group that promotes medical quality, funded a working group to develop suggestions for changing a culture of rampant gift acceptance among doctors.

The group recommended that drug and devicemakers should be prohibited from giving doctors any gifts, including meals, payment for travel and participating in continuing medical education. And, it says, doctors should stop accepting free drug samples.

Because many doctors like samples and give them to poor patients, the group urged drugmakers to provide vouchers for low-income patients.

Drug companies alone spend more than $20 billion on total marketing each year, about 90 percent of which is directed at physicians.

But some say doctors and hospitals should be troubled by little gifts and particularly cautious of money drugmakers bill as educational support.

"There is no reason to think even small gifts do not influence (doctors) either consciously or unconsciously," said Dr. Jordan Cohen, president of the Association of American Medical Colleges. "The only purpose of that gift is to curry favor."

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