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Pharmaceutical Industry Gifts to Physicians: Patient Beliefs and Trust in Physicians and the Health Care System

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ABSTRACT

BACKGROUND

Pharmaceutical industry gifts to physicians are common and influence physician behavior. Little is known about patient beliefs about the prevalence of these gifts and how these beliefs may influence trust in physicians and the health care system.

OBJECTIVE

To measure patient perceptions about the prevalence of industry gifts and their relationship to trust in doctors and the health care system.

DESIGN

Cross sectional random digit dial telephone survey.

PARTICIPANTS

African-American and White adults in 40 large metropolitan areas.

MAIN MEASURES

Respondents’ beliefs about whether their physician and physicians in general receive industry gifts, physician trust, and health care system distrust.

KEY RESULTS

Overall, 55% of respondents believe their physician receives gifts, and 34% believe almost all doctors receive gifts. Respondents of higher socioeconomic status (income, education) and younger age were more likely to believe their physician receives gifts. In multivariate analyses, those that believe their personal physician receives gifts were more likely to report low physician trust (OR 2.26, 95% CI 1.56–3.30) and high health care system distrust (OR 2.03, 95% CI 1.49–2.77). Similarly, those that believe almost all doctors accept gifts were more likely to report low physician trust (OR 1.69, 95% CI 1.25–2.29) and high health care system distrust (OR 2.57, 95% CI 1.82–3.62).

CONCLUSIONS

Patients perceive physician–industry gift relationships as common. Patients that believe gift relationships exist report lower levels of physician trust and higher rates of health care system distrust. Greater efforts to limit industry–physician gifts could have positive effects beyond reducing influences on physician behavior.

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Funding

This research was supported by the National Human Genome Research Institute (R01 HG 2689–01) and the American Cancer Society (Research Scholar Award PBP-104351). David Grande receives support from the HealthWell Foundation.

Prior Presentations

Presented in part at the Society of General Internal Medicine Annual Meeting, May 14, 2009, Miami, FL.

Conflicts of Interest

Dr. Grande reports serving as an expert witness on behalf of the Attorney General of the State of Vermont in a case concerning pharmaceutical marketing. Dr. Grande served a term ending March 2011 as a voluntary member of the Board of Directors of the National Physicians Alliance.

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Authors and Affiliations

  1. Department of Medicine, University of Pennsylvania, 3641 Locust Walk – Room 407, Philadelphia, PA, 19104, USA

    David Grande MD, MPA, Judy A. Shea PhD & Katrina Armstrong MD, MSCE

  2. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA

    David Grande MD, MPA, Judy A. Shea PhD & Katrina Armstrong MD, MSCE

  3. Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA

    Katrina Armstrong MD, MSCE

Authors
  1. David Grande MD, MPA
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  2. Judy A. Shea PhD
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  3. Katrina Armstrong MD, MSCE
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Corresponding author

Correspondence to David Grande MD, MPA.

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Grande, D., Shea, J.A. & Armstrong, K. Pharmaceutical Industry Gifts to Physicians: Patient Beliefs and Trust in Physicians and the Health Care System. J GEN INTERN MED 27, 274–279 (2012). https://doi.org/10.1007/s11606-011-1760-3

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  • DOI: https://doi.org/10.1007/s11606-011-1760-3

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