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Many thanks to Lisa Day and AJCC for publishing the Current Controversies column titled "Industry Gifts to Healthcare Providers: Are the Concerns Serious?"¹ In the article, Day questions the appropriateness of healthcare providers accepting gifts from industries that support healthcare, such as pharmaceutical companies. She explains that anthropologists, who have studied gift exchange in this type of setting, concur that it is always seen as an exchange. If this were not the case, why would pharmaceutical and medical device sales representatives find it necessary to offer free lunches and free pens?

Although the notorious "free lunch" is the classic example of gifts that medical industry supporters frequently use, many others exist. Methods such as prescriber kickbacks, in which the prescriber actually gets paid to prescribe a certain drug, as well as all-expense-paid trips, are other techniques that influence healthcare providers’ prescribing practices. Day explains that studies have confirmed that this type of selling practice affects what physicians prescribe. The more contact between sales representatives and the doctor, the more likely the doctor is to use the product being sold. Although the federal government has instituted laws against these types of industry-provider relationships, the financial gain that takes place in the relationship between pharmaceutical/medical device sales representatives and healthcare providers is seen as indirect, and therefore they are able to bypass these laws.

As a healthcare provider, I am concerned that my colleagues might opt to prescribe a less effective medication in exchange for a gift or a kickback. It seems today that healthcare providers are too easily persuaded to maneuver away from good patient care, which should be our No. 1 priority. All health-care providers should make decisions based on what is best for their patients, not on whether they will receive a free lunch or an all-expense-paid vacation.

My hope is that by raising this issue for discussion, Day can help to convince healthcare providers that relationships with sales representatives, with whom gift exchanges take place, are not appropriate and should come to an end for the good of patients.

Rebecca F. Humphries, RN, BSN
West Georgia Health System, LaGrange, Georgia

REFERENCE

1. Day L. Industry gifts to healthcare providers: are the concerns serious? Am J Crit Care. 2006;15(5):510–513.[Free Full Text]

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