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Durban – From pens and lanyards to holidays abroad, that South African doctors were accepting gifts from pharmaceutical firms was “common” practice, which was “unacceptable” to patients.
A study by two anaesthetists from the University of KwaZulu-Natal has found that 80 percent of patients believe that doctors could, in this way, be swayed about which drugs and products they prescribed.
The research, by Robert Wise and Reitze Rodseth, has been published in the Southern African Journal of Anaesthesia and Analgesia, and was conducted at Grey’s Hospital in Pietermaritzburg.
The respondents were a sample of 200 patients.
“The physician-patient relationship is built on trust, with an understanding that the physicians will act ethically and in patients’ best interests,” Wise and Rodseth said.
“Gift giving is a technique that is commonly used by the pharmaceutical industry to generate feelings of reciprocity and obligation in physicians, and research has clearly demonstrated that physicians are susceptible to this practice,” the authors said.
Rodseth said that there had been little research into patients’ perceptions of the relationship between doctors and the pharmaceutical industry.
Sixty-two percent of patients felt that it was wrong for doctors to receive even small gifts (pens, notepads, mugs, cooler bags).
When asked which sort of gifts doctors should be allowed to receive, patients believed sponsorship to attend educational conferences was acceptable, because it supplemented doctors’ knowledge.
Wise and Rodseth said the pharmaceutical industry played an important role, in exposing doctors to new devices, technology, information and training.
“The relationship between doctors and the medical industry is necessary, but existing aspects of this practice are unacceptable to patients and should be reviewed.”
Rodseth said that no punitive action could be taken against a doctor for accepting gifts, unless it could be proved that it was a bribe or backhander.
Rodseth confirmed that the majority of doctors were not of the view that accepting gifts was wrong – because they did not believe they could be swayed.
The South African Code of Practice for the Marketing of Medicine says gifts and promotional items must be inexpensive, of minimal intrinsic value, not for personal use, and have educational and/or scientific value to benefit the patient.
The code also encourages pharmaceutical firms to publicly disclose information on gift giving.
The code is under review, and it is hoped that it will provide more definite recommendations on the permissible value of gifts, clear forms of regulation, and compulsory disclosure.
Asked whether gift giving could be detrimental to a patient’s health, Rodseth said that doctors could be influenced to prescribe medicine that might not be “the cheapest or the best”.
“You can talk about your product, but don’t give me your pen,” was his approach, Rodseth said.
leanne.jansen@inl.co.za
The Mercury
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