Editor—I am always amazed by the naivety of my colleagues as they accept yet another free lunch/pen/foreign trip.1 They fail to recognise the sophistication of pharmaceutical marketing and excuse their behaviour on various grounds:
“It doesn't influence me.” If this were true, drug representatives would lose interest and move on to someone who is more easily influenced
“The NHS cannot afford postgraduate education without sponsorship.” Sponsorship comes from NHS funds, paid to the companies in exchange for expensive drugs. If drugs had discounts perhaps education would be affordable. Courses that do not result in increased drug sales find sponsorship hard to obtain.
Doctors do not realise that this behaviour is not usual. Most staff in either the public or private sector are not permitted to accept significant hospitality from those who sell products to their organisation. Many are horrified at the willingness of doctors to see sales represenatives and accept lavish hospitality.
One answer to inappropriate drug company promotion is openness and disclosure. Every healthcare organisation/hospital trust/general practice should develop a code of conduct that includes a public register of interests listing all hospitality, sponsorship, and gifts. Doctors who do not abuse their position have nothing to fear from this.
Annual appraisal provides an opportunity for doctors to reflect on their relationship with the pharmaceutical industry. The appraisal form could list gifts, hospitality, and sponsorship and the appraisal include discussion on how this has influenced practice and whether they need to change their behaviour.
Competing interests: CP is responsible for giving advice and support on prescribing to the 400 or more general practitioners in the Eastern Area of Northern Ireland. He does not accept drug company sponsorship or gifts.
References
- 1.Abbasi K, Smith R. No more free lunches. BMJ 2003;326: 1155-6. (31 May.) [DOI] [PMC free article] [PubMed] [Google Scholar]