BMJ  2004;328:1032 (1 May), doi:10.1136/bmj.328.7447.1032-a

News

US junior doctors found to be ignorant of drug companies' tactics

Quebec

Although drug companies spend billions of dollars on marketing their products and have been successful in influencing doctors' prescribing decisions, a new study shows that only a small proportion of medical residency programmes in the United States teach doctors how to deal with such pressures ( Academic Medicine 2004;79: 432-7[CrossRef][ISI][Medline]).

Dr Raquel Watkins, lead author of the study and assistant professor of internal medicine at Wake Forest University Baptist Medical Center, North Carolina, said there is "a compelling need for innovative approaches to provide residents with the skills, knowledge, and attitudes to interact appropriately with pharmaceutical representatives."

"The goal of pharmaceutical industry marketing is to change physicians' behaviours. Recent literature shows that gifts influence the prescribing patterns of physicians; can have a negative impact on physicians' knowledge, attitudes, and behaviours; and result in increasing costs," the article says.

To be informed decision makers, doctors need to be aware of this potential conflict of interest, Dr Watkins said. Yet, she and co-author Dr James Kimberly Junior, also assistant professor at Wake Forest, found through a review of published manuscripts that only 25% of internal medicine residency programmes in the United States have formal instruction on how to interact with drug companies' sales representatives.

The authors say that a questionnaire survey at their university medical centre in 2001—with a 97% response rate for residents and 79% for faculty members—found low levels of knowledge about the impact of marketing strategies on prescribing patterns.

According to the survey less than 9% of the residents—who had trained at 46 different medical schools—were familiar with guidelines from professional organisations and research on interactions between doctors and the industry.

The authors developed a six hour curriculum to teach internal medicine residents about the ethics of their interactions with drug company representatives and about the potential for their prescribing patterns to be influenced. Training included videotaped interviews with patients in which they said how they were affected by drug prices and gave their thoughts on gifts from drug companies to doctors. The residents were taught how to critically interpret promotional materials strategies. and marketing

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Rapid Responses:

Read all Rapid Responses

becoming aware of a relevant problem

Giovanni Codacci-Pisanelli
bmj.com, 30 Apr 2004 [Full text]

Problem may be worse in developing countries

Ashwani Singal
bmj.com, 1 May 2004 [Full text]

Pharmaceutical Companies and CME

Bernard C Boyd
bmj.com, 5 May 2004 [Full text]

Skills, knowledge, attitudes, and practice in the shadow of pharmaceutical representatives!

Dr.Naseem A. Qureshi MD, IMAPA, LMIPS
bmj.com, 5 May 2004 [Full text]