Date: 10 Mar 2012
Of mugs, meals and more: the intricate relations between physicians and the medical industry
- Stephan Sahm
- … show all 1 hide
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Empirical research has proven the influence exerted by the medical industry on physicians’ decision-making. Physicians are the gatekeepers who determine how money is spent within the healthcare system. Hence, they are the target group of powerful lobbies in the field, i.e. the manufacturers of medical devices and the pharmaceutical industry. As clinical research lies in the hands of physicians, they play an exclusive and central role in launching new medical products. There are many ethical problems involved here: physicians may develop a mindset of entitlement; biased decisions may put patients at risk; academic interests and research activities will no longer be free if they are influenced considerably by financial incentives; fair resource allocation may be restricted. An aspect that has been neglected so far is the administrators’ involvement as they not rarely expect physicians to acquire external financial resources from industry as benefits often lie with the institutions. To “protect” physicians from undue sway may be in the best interest of patients in order to guarantee a fair allocation of resources and to prevent the application of technologies (and medications) that would not have been used according to current standards of care. The latter may and obviously does put patients at risk. On the other hand, medico–industrial relations are of great importance. A considerable part of medical progress is driven by private industry. Yet, any co-operation between those who care for patients and industry ultimately has to serve the patient. Hence, strong policies to guide conduct are sorely needed. The following points are held to be pivotal in order to secure ethical conduct: (1) professional codes of ethics; (2) a stronger academic attitude amongst medical staff, (3) rules of transparency for medico−industrial relations including online disclosure and limiting scale of payments, (4) establishing rules (and laws) that ban unethical conduct and mandate vigorous surveillance of adherence to guidelines.
Angell, M. 2009. Drug companies & doctors: A story of corruption. New York Review of Books.
Bero, L., F. Oostvogel, P. Bacchetti, and K. Lee. 2007. Factors associated with findings of published trials of drug–drug comparisons: Why some statins appear more efficacious than others. PLosMed 2007(4): e184.
Bhandari, M., J.W. Busse, D. Jackowski, V.M. Montori, H. Schünemann, S. Sprague, D. Mears, E.H. Schemitsch, D. Heels-Ansdell, and P.J. Devereaux. 2004. Association between industry funding and statistically significant pro-industry findings in medical and surgical randomized trials. Canadian Medical Association Journal 170: 477–480.PubMed
Drazen, J.M., P.W. de Leeuw, C. Laine, C. Mulrow, C.D. DeAngelis, F.A. Frizelle, F. Godlee, C. Haug, P.C. Hébert, A. James, S. Kotzin, A. Marusic, H. Reyes, J. Rosenberg, P. Sahni, M.B. Van Der Weyden, and G. Zhaori. 2010. Toward more uniform conflict disclosures—the updated ICMJE conflict of interest reporting form. New England Journal of Medicine 363: 188–189.PubMedCrossRef
Echardt V 2010. Personal communication.
Eckardt, V. 2000. Complimentary journeys to the World Congress of Gastroenterology–an inquiry of potential sponsors and beneficiaries. Zeitschrift für Gastroenterologie 38: 5–6.CrossRef
Fugh-Berman, A. 2005. The corporate coauthor. Journal of General Internal Medicine. 20:546–548.
Fullerton, C.A., A.B. Busch, and R.G. Frank. 2010. The rise and fall of gabapentin for bipolar disorder: A case study on off-label pharmaceutical diffusion. Medical Care 48(4): 285–287.CrossRef
Jørgensen, A.W., J. Hilden, and P.C. Gøtzsche. 2006. Cochrane reviews compared with industry supported meta-analyses and other meta-analyses of the same drugs: Systematic review. British Medical Journal 14(333): 782.CrossRef
Kelly, R.E., L.J. Cohen, R.J. Semple, P. Bialer, A. Lau, A. Bodenheimer, E. Neustadter, A. Barenboim, and I.I. Galynker. 2006. Relationship between drug company funding and outcomes of clinical psychiatric research. Psychological Medicine 2006(36): 1647–1656.CrossRef
Lesser, L.I., C.B. Ebbeling, M. Goozner, D. Wypij, and D.S. Ludwig. 2007. Relationship between funding source and conclusion among nutrition-related scientific articles. PLoS Med 2007(4): e5.CrossRef
Lo, B., and M.J. Fields (eds.). 2009. Conflict of interest in medical research, education and practice. Washington, DC: The National Academy Press.
Peppercorn, J., E. Blood, E. Winer, and A. Partridge. 2007. Association between pharmaceutical involvement and outcomes in breast cancer clinical trials. Cancer 2007(109): 1239–1246.CrossRef
Rogers, W.A., P.O. Mansfield, A.J. Braunack-Mayer, and J.N. Jureidini. 2004. The ethics of pharmaceutical industry relationships with medical students. Medical Journal of Australia 2004(180): 411–414.
Rothman, D.J., W.J. McDonald, C.D. Berkowitz, S.C. Chimonas, C.D. DeAngelis, R.W. Hale, S.E. Nissen, J.E. Osborn, J.H. Scully, G.E. Thomson, and D. Wofsy. 2009. Professional medical associations and their relationships with industry: A proposal for controlling conflict of interest. Journal of the American Medical Association 301: 1367–1372.PubMedCrossRef
Sahm, S.W. 2008. Autonomie, ärztliche Indikation und Entscheidungsfindung. In Medizinische Indikation und Patientenwille, ed. R. Charbonnier, K. Dörner, and S. Simon, 121–131. Stuttgart: Schattauer.
Schott, G., H. Pachl, U. Limbach, U. Gundert-Remy, W.D. Ludwig, and K. Lieb. 2010a. The financing of drug trials by pharmaceutical companies and its consequences. Part 1: a qualitative, systematic review of the literature on possible influences on the findings, protocols, and quality of drug trials. Deutsches Aerzteblatt International. 107:279–285 (Epub 2010 Apr 23).
Schott, G., H. Pachl, U. Limbach, U. Gundert-Remy, W.D. Ludwig, and K. Lieb. 2010b. The financing of drug trials by pharmaceutical companies and its consequences: Part 2: a qualitative, systematic review of the literature on possible influences on authorship, access to trial data, and trial registration and publication. Deutsches Aerzteblatt International. 107:295–301 (Epub 2010 Apr 30).
Sculier, J.P. 2010. Conflicts of interest: A concept often (voluntary) ignored by physicians. Revue Medicale de Bruxelles 3: 199–205.
Soyk, C., B. Pfefferkorn, P. McBride, and R. Rieselbach. 2010. Medical student exposure to and attitudes about pharmaceutical companies. World Medical Journal 109: 142–148.
Zinner, D.E., D. Bolcic-Jankovic, B. Clarridge, D. Blumenthal, and E.G. Campbell. 2009. Participation of academic scientists in relationships with industry. Health Affairs 2009(28): 1814–1825.CrossRef
- Of mugs, meals and more: the intricate relations between physicians and the medical industry
Medicine, Health Care and Philosophy
Volume 16, Issue 2 , pp 265-273
- Cover Date
- Print ISSN
- Online ISSN
- Springer Netherlands
- Additional Links
- Conflict of interest
- Pharmaceutical industry
- Clinical practice
- Clinical research
- Continuing medical education
- Medico−industrial relations
- Industry Sectors
- Stephan Sahm (1) (2)
- Author Affiliations
- 1. Medical Clinic I, Ketteler Hospital, Lichtenplattenweg 85, 63071, Offenbach, Germany
- 2. Institute for History and Ethics in Medicine, Goethe University, Frankfurt/Main, Germany