Feature Archive

A Prescription for Trouble

Are your doctors influenced by drug company perks?

WebMD Feature

April 10, 2000 (San Francisco) -- Once upon a time, the perks were scandalous.

During the 1980s, drug companies offered physicians gifts of all kinds, from penlights to personal computers and plane tickets, to promote their medications. Of course, these freebies telegraphed a not-so-subtle message to doctors: Prescribe our drug, and the perks will keep coming.

All that changed in 1991: Pressured by Congress, the American Medical Association (AMA) adopted ethics guidelines calling on physicians to refuse any gift of "substantial value," including meals, entertainment and cash. Thus ended some of the more egregious practices, such as awarding frequent flyer miles based on the number of prescriptions a doctor wrote.

But a recent editorial in the January 19 issue of the Journal of the American Medical Association (JAMA) brings bad news: "Many of the troubling practices have returned," says Robert Tenery Jr., MD, a past chair of the AMA's Council on Ethical and Judicial Affairs. Instead of plane trips, Tenery says drug companies are now handing out honoraria and free lunches, and sponsoring "educational" seminars at which drug companies control everything from the choice of salad to the setting, the science, and the speakers.

To make matters worse, physicians often attend these seminars in order to satisfy the continuing medical education (CME) requirements that they must fulfill to keep their state licenses current.