Appropriateness of Collaborations between Industry and the Medical Profession: Physicians’ Perceptions

A recent study in The American Journal of Medicine, examined the collaborations that exist between physicians and the pharmaceutical industry, and whether physicians perceive this interaction as an innate evil even when such interactions are addressed and the relationships between physicians and industry are transparent.

The study was funded in part by the Attorney General Consumer and Prescriber Grant Program administered by the State of Oregon for data collection. Dr. Joseph S. Ross, who carried out the study, was compensated for his work as a consultant at the request of plaintiffs in litigation against Merck and Co., Inc. related to rofecoxib from 2006-2007. 

Conducted at the Mount Sinai School of Medicine in New York City and New Jersey, investigators surveyed faculty and postgraduate physicians from all departments within the 11 affiliated hospitals with. 590 surveys were completed by physicians at 9 hospitals.  Physicians' assessment of appropriateness of collaboration with industry found that:

· 92% found it appropriate to work together in developing a drug or device

· 91% found it appropriate to work together to design a drug/device trial

· 60% found it appropriate to work together in preparing a manuscript of a drug/device trial

· 65% found it appropriate to work together to recruit patients for a drug/device trial

· 65% found it appropriate for physicians not involved in trial design to  work with industry

· 81% rated receiving payment to develop a drug or device as appropriate; and

· 38% rated receiving payment appropriate to recruit patients for a drug/device trial when the physician was not involved in trial design.

The authors of the study concluded that “physicians' broadly perceived most collaboration with the pharmaceutical and medical device industries, and of receiving payment for collaboration, as appropriate.

This is a significant finding especially given that the author Joseph Ross, MD has been one of the most important consultants in the Vioxx trials for the plaintiff attorneys.   The evidence that physicians believe it is appropriate to work with industry including in the development of manuscripts, receiving payments, clinical trial design and recruitment, holds true despite Dr. Ross’s biases to the contrary.  

This study shows that before we dismantle the entire system of industry physician collaboration, it is important to include “real doctors” not just industry critics and ethicists in the discussion, as this may be dismantling a system that has proven to work.  Given this study, even our critics will have to accept that those who advocate a separation of physicians and industry are a small but vocal minority.