A survey was published in NEJM, 26 April 2007, "A national survey of physician - industry relationships" prompted by the concerns of conflicts of interet.
About 3000 physicians were surveyed between 2003 and 2004, more than half responded. The survey found that 94% of physicians in the US have some form of relationships with the industry reps and the relationships vary depending on the specialty, practice type and professional activities :
83% have received gifts especially food in the workplace;
78% free drug samples;
35% reimbursements for expenses;
28% payments for consulting, speaking, enrolling patients in clinical trials;
7% tickets to entertainments
Cardiologists were more than twice likely to receive fees than family practitioners and other physicians
Physicians in solo or group practices were much more likely to have these relationships than those working in hospitals and clinics.
Family practitioners met "far more often" with industry sales reps and the most likely to receive gifts than other doctors
All specialties except anesthesiology have more frequent meetings with industry today as compared to 2000.
A new code of conduct governing physician–industry relationships was established in 2002 to limit the value of gifts to physicians from industry, but the survey found that some of the physicians failed to observe the guidelines. The findings suggest that the drug industry form tighter relationships with opinion leaders for marketing as they are likely to influence the prescribing practices of other doctors. This has raised the question of "to what extent do these relationships benefit patients?"
In the same week, the journal PLoS Medicne published an article, "Following the script: how drug reps make friends and influence doctors", revealing the strategies deployed relentlessly by reps to influence physicians prescribing. This includes forming false "friendships" with physicians, supplying carefuly selected gifts, drug samples, services and flattery to physicians depending on the information the reps have collected about the physicians' personality types.
Most physicians deny that gifts and freebies could influence their behaviour, but several studies have shown that industry reps are extremely effective in changing prescribing behaviour. Evidence also suggests the information provided to physicians may be largely incorrect. The researcher concluded that "physicians must rely on information on drugs from unconflicted sources and seek friends among those who are not paid to be friends."
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