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W. Paul McKinney, MD; David L. Schiedermayer, MD; Nicole Lurie, MD, MSPH; Deborah E. Simpson, PhD; Jesse L. Goodman, MD; Eugene C. Rich, MD

JAMA. 1990;264(13):1693-1697.

Abstract
We surveyed faculty and residents from seven hospitals affiliated with three academic internal medicine training programs about their perceptions of the informational and service benefits vs the risks of ethical compromise involved in interactions with pharmaceutical sales representatives. Questionnaires were returned by 467 (81%) of 575 physicians surveyed. Residents and faculty generally had somewhat negative attitudes toward the educational and informational value of detailing activities at their institutions but indicated that representatives supported important conferences and speakers. Residents were more likely than faculty to perceive contacts with sales representatives as potentially influencing physician decision making. Sixty-seven percent of faculty and 77% of residents indicated that physicians could be compromised by accepting gifts. More than half of the physicians who suggested that such compromise was possible indicated that acceptance of gifts worth more than $100 from drug companies would be likely to compromise a physician's independence and objectivity. A majority of both faculty and house staff favored eliminating presentations by pharmaceutical representatives at their hospitals. Only 10% thought they had had sufficient training during medical school and residency regarding professional interaction with sales representatives.

(JAMA. 1990;264:1693-1697)

Author Affiliations
From the Division of General Internal Medicine (Dr McKinney), Center for the Study of Bioethics (Dr Schiedermayer), and Educational Services Department (Dr Simpson), Medical College of Wisconsin, Milwaukee; Division of General Internal Medicine, Hennepin County (Minnesota) Medical Center and School of Public Health, University of Minnesota, Minneapolis (Dr Lurie); Division of Infectious Diseases, University of Minnesota, Minneapolis (Dr Goodman); and Division of General Internal Medicine, St Paul (Minn) Ramsey Medical Center (Dr Rich). Dr Rich is now with the Division of General; Internal Medicine, University of Kentucky Medical Center, Lexington. Dr McKinney is now with the Division of General Internal Medicine, University of Texas Southwestern Medical Center, Dallas.

Footnotes
The opinions expressed are those of the authors and do not necessarily represent those of the institutions or foundations with which they are associated.

Reprint requests to Medical Service (III), Dallas Veterans Administration Medical Center, 4500 S Lancaster Rd, Dallas, TX 75216 (Dr McKinney).

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