Dear colleagues: I am looking forward for your valued contributions on this topic

Fahmi,

Your question has been an issue for some time now and for every study that shows gifts can influence decision making there are studies that show the opposite. I believe it is important to remember that physicians belong to a profession that is built on ethical behavior. My observations with 40 plus years in the orthopaedic heath care field are that certain gifts like medical books or teaching aids are appropriate but gifts of wine or tickets to events should not be done.

Disclosure is an important factor and all should error by disclosing any activity that can bring into question ones integrity. I do not believe we should ban gifts but I do believe ethical behavior can and should be taught and each individual professional society should establish its own guidelines.

The Peer to Peer guidelines in ones profession should be enough pressure to ensure proper behavior. If you are inclined to breach ethical behavior it will eventually catch up with you and there generally is a price to be paid.

As for guidelines for industry behavior that is a different issue. Industry at large does not have the same historical teachings as does the medical profession. Industry because of past performance now has restrictions placed on them by the Department of Justice. Example: Contract law has allowed physicians to be paid a royalty for endorsement of products or pharmaceuticals. The Justice Department has established public policy that royalty payments can now only be paid for transfer of intellectual property. This is a restriction that does not effect any other profession.

Most patients accept the fact that if their doctor is a developer or consultant to industry then he must be better than average. The mistake physicians can make is in not disclosing that information to their patients. If something goes wrong and legal discovery shows the physician has failed to warn the patient of that fact it could have a significant outcome against the physician.

I believe a good guideline on behavior is the fact if the person is reluctant to disclose the activity that is an indication that he probably should not be engaging in that behavior.

Many thanks timothy,

I think we should ban the personal relations between physicians and drug companies as this relation usually spoils the physicians behavior and I agree with you on that, the relation between drug companies and health care organizations should be regulated by clear guidelines.

I would not go as far as to banning a personal relationship. Often these relationships develop over many years of working side by side. But ones true friend does not put a friend into harm's way bay asking or expecting anything but proper business behavior. Treat people with kindness and respect and that is the way they will treat you back.

However, what is happening nowadays is disappointing. Drug company's representatives are exploiting gifts and other temptations to push physicians to prescribe their products. This is a good reason for banning or at least regulating the personal relation between physicians and drug companies.

Physicians need to stand on their own strength of character. If they start playing games about accepting gifts for using product or services it will eventually cost them their professional credibility and they will jeopardize their own ability to maintain their livelihood. No one wins when they take short cuts. Professional societies need to set policy and hold their members accountable period.

You are right, Thanks Timothy.