This post courtesy of Anne Taylor-Vaisey:

Here is an interesting study that was published in the August 2004 issue of the International Journal of Radiation Oncology*Biology*Physics (IJROBP). The authors state: To our knowledge, this study represents the first large-scale population based study of a hospital-based specialty and gift giving.

Halperin EC, Hutchison P, Barrier RC Jr. A population-based study of the prevalence and influence of gifts to radiation oncologists from pharmaceutical companies and medical equipment manufacturers. Int J Radiat Oncol Biol Phys. 2004 Aug 1;59(5):1477-83.

Office of the Vice Dean, Duke University Medical Center, Durham, NC 27710, USA. halpe001@mc.duke.edu

PURPOSE: Hospital-based physicians are responsible for the purchase of expensive equipment. Little is known about the influence of gift giving on their behavior. We wanted to ascertain the prevalence of gift giving from the pharmaceutical ind! ustry and medical equipment manufacturers to radiation oncologists and determine whether or not the size of accepted gifts influences their opinions regarding gifts.

METHODS AND MATERIALS: A population-based survey of hospital-based physicians conducted between 2002 and 2003. The study population consisted of all radiation oncologists who were members of the American Society of Therapeutic Radiology and Oncology between 2000 and 2001. A random number generator was used to identify 20% of the population. This group was invited by e-mail and conventional mail to complete a Likert scale questionnaire. Those asked to complete the questionnaire electronically were directed to a specially designed web site.

RESULTS: Of 640 individuals who were asked to participate, 241 (38%) completed the questionnaire. 96% admitted accepting gifts. The most commonly accepted low value gifts were: pen or pencil (78%), drug samples for patient’s use (70%), meal (66%), and a note pad (59%). The most ! commonly accepted high value gifts were trips to “equipment-users meetings” (15%), honoraria for speaking at a conference (10%), and participation in a conference call (9%). Only 5% of radiation oncologists agreed with the statement “my prescribing practices are affected” by gifts; however, 33% agreed with the statement “I believe that other physicians prescribing practices are affected.” Similarly, although only 4% felt that their recommendations concerning purchases of medical equipment are affected by gifts, 19% felt that other physicians would be influenced. A test of the hypothesis that physicians believe that their conduct is less affected than those of their colleagues (i.e., “I am not influenced by gifts but someone else is” was strongly affirmed by a correlation statistic) (p < 0.0001). Of the radiation oncologists surveyed, 74% felt that they should be free to accept gifts of small value, 31% felt they should be free to accept meals or gifts of any type, 16% felt that r! esidency programs should ban free meals provided by companies, 13% felt professional associations should discourage companies from hosting parties at the annual meeting, 17% felt that gift giving should stop, and 66% agreed that clinical information provided by companies provides a useful continuing medical education service. Those who accepted larger gifts were far more likely to disagree with statements such as "professional societies should actively discourage companies from hosting parties and providing free meals and giving gifts to physicians attending the annual meeting" (p = 0.0003) and "the practice of gift giving by companies should stop" (p = 0.0017); they were slightly more likely to agree with statements such as "clinical information provided to radiation oncologists by companies provides a useful continuing medical education service."

CONCLUSIONS: To our knowledge, this study represents the first large-scale population based study of a hospital-based specialty and ! gift giving. This study demonstrates that:

(1) Gift giving in radiation oncology is endemic.

(2) Although each physician is likely to consider himself or herself immune from being influenced by gift giving, he or she is suspicious that the "next person" is influenced.

(3) There is a correlation between the willingness of individual physicians to accept gifts of high value and their sympathy toward this practice.

MeSH Terms:

* Attitude of Health Personnel

* Conflict of Interest*

* Data Collection

* Drug Industry/statistics & numerical data*

* Equipment and Supplies, Hospital/statistics & numerical data*

* Gift Giving*

* Human

* Radiation Oncology/statistics & numerical data*

* Support, Non-U.S. Gov't

* United States

PubMed link

Journal abstract

While e-education is getting hotter all the time for some types of adult learners, docs still don t like to get their continuing medical education online, according to the second annual Pri-Med CME Insight Survey. Even with a 25 percent growth in e-CME this year among primary care physicians, “eCME is the preferred learning channel for only one physician in ten.” But Pri-Med thinks this will continue to be a growth area. From a press release:

“By a wide margin, medical meetings remain the preferred source for continuing medical education among physicians,” said Anne Goodrich, research director of the Pri-Med Institute. “While eCME today accounts for only 10% of all CME credits earned by primary care physicians, it is clearly an educational channel that is beginning to reach a broader audience,” she said.



The 2004 Pri-Med CME Insight survey of primary care physicians throughout the US found that live educational forums remain the preferred source of CME by a margin of four-to-one, followed by enduring materials, professional journals and eCME respectively. Currently, the least popular learning method is hospital grand rounds.

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