Physicians and the Pharmaceutical Industry

Wazana,A. (2000), Physicians and the pharmaceutical industry is a gift ever just a gift , Journal of the American Medical Association, 283, 373-80. 

Wazana A. Physicians and the Pharmaceutical Industry Is A Gift Ever Just a Gift JAMA 2000 283(3) 373-380. 

Next, Ian Marshall examines the relationship between physicians and the pharmaceutical industry and the issue of gift-giving to physicians. He enumerates several codes that are in place to regulate the relationship and notes that one major deficiency is that they are not being vigorously enforced. 

Notwithstanding this overlapping of interests, physicians and the pharmaceutical industry each have a different emphasis and they focus on different stakeholders. The pharmaceutical companies principal emphasis is the encouragement of the use of their products the physicians primary emphasis is effective patient care. The primary stakeholder in patient care is the patient while the principal stakeholder in industry is the shareholder (Komesaroff and Kerridge 2002). However, the relationship between physicians and the pharmaceutical industry is often more complex, as each party may be influenced by a variety of different interests and stakeholders, e.g., community welfare. 

It should not be assumed that where a duality of interest occurs between physicians and the pharmaceutical industry there will always be a conflict of interest. Dualities of interest constitute "conflicts" only when they are associated with competing obligations that are likely to lead directly to a compromise of primary responsibilities (Komesaroff and Kerridge 2002). 

While emphasizing patient care, the general approach used by the CMA policy on Physicians and the Pharmaceutical Industry (CMA 2001) is not inconsistent with that used by the AMA and the ACP. One of the general principles of the CMA policy requires the primary objective of interactions between physicians and industry to be the advancement of health of Canadians rather than the private good of physicians or industry. Another is that relationships with industry are appropriate only insofar as they do not negatively affect the fiduciary nature of the patient-physician relationship. The principles also instruct physicians to resolve any conflict of interest between themselves and their patients resulting from interactions with industry in favor of their patients. They specifically warn physicians to avoid any self-interest in their prescribing and referral practices (CMA 2001). 

Barber 1998). To achieve a truly symbiotic relationship between physicians and the pharmaceutical industry, the light of transparency is required to dispel the darkness where conflict of interest, conspiracy, and corruption can thrive. 

Canadian Medical Association. 2001. CMA Policy Physicians and the Pharmaceutical Industry Update 2001. Available at http //www.cma.ca [Accessed November 15, 2005]. 

In December 2004, the Norwegian Medical Association and LMI jointly laid down an ethical code and guidelines on cooperation and interactions between physicians and the pharmaceutical industry. 

American College of Physicians. 1990. Physicians and the pharmaceutical industry. Annals of Internal Medicine 112 624-626. 

---