The Effect of a Seminar Series on Third Year Students' Attitudes Toward the Interactions of Drug Companies and Physicians

摘要

BackgroundMedical students are frequently subjected to the influences of pharmaceutical companies including gifts and food. These interactions while seemingly trivial can lead to prescribing habits that are not in the best interests of patients. We have instituted a seminars series reviewing articles about these interactions.MethodsA questionnaire was developed to evaluate changes in students' attitudes before and after the seminars. A control group who didn't take part in the seminars was also evaluated. ResultsSome groups of students had a statistically significant more cautious attitude towards pharmaceutical companies after the seminar. Female students were statistically less likely to accept gifts after the seminar series.ConclusionsA seminar series concerning the influences of pharmaceutical companies on physicians can produce significant changes in some students' attitudes towards drug company gifts. Introduction The interaction between physicians and pharmaceutical companies is becoming an area of great concern to both the medical profession and the public.1 The acceptance of gifts from pharmaceutical representatives, the funding of CME activities, the payment for speaking, and the funding of research have all been viewed as possible sources of conflict of interest for physicians in their dealings with their patients.2,3 While numerous studies have demonstrated the effects of pharmaceutical firm's enticements on the prescribing behavior of physicians it is hoped that early intervention during medical school might allow the students to better understand the conflict of interest that occurs when gifts and other financial incentives are accepted . 4,5,6 Presently medical students' attitudes towards this interactions are often permissive and recommendations by the Accreditation Council on Graduate Education for stricter policies have not produced results at most medical schools.7 Medical students are felt to be at particular risk for unrecognized influence by pharmaceutical company marketing efforts. 8 A program at one medical school utilized pharmacist to play the role of pharmaceutical representatives to model a promotional presentation to medical students enabling the students to think critically about how these presentations might affect their eventual prescribing practices. A curriculum for family practice residents that consisted of a faculty-led debate and discussion of a review of physician-pharmaceutical industry interactions was found to promote more cautious attitudes toward pharmaceuticals marketing. 10 Such programs are very important and describe some methods that could be used to explore the complex issues involved with physician and pharmaceutical company interactions.At Jefferson Medical College a series of 4 seminars were conducted with 3rd year medical students to explore their attitudes towards pharmaceutical and physician interactions before and after a discussion of leading journal articles and current books on the topic. Articles were specifically chosen to represent as much as possible various outlooks on the issues. Topics such as the effect of gifts from pharmaceutical representatives and subsequent prescribing practices, the actual amount of money spent on drug development and the influence of pharmaceutical companies on medical journals were explored. Articles on such topics as the dangers of over governmental regulation and importance of developing new drugs were used to balance the discussions. Each student was assigned an article to present to his/her fellow students. Having the students conduct the presentations was found to be a very effective way of making sure that the students were fully engaged in the seminars. A faculty member(FWM) was present to serve as a moderator and to make sure that the discussion covered all of the key areas. Methods The participants in this study were medical students who were taking their third-year Family Medicine Clerkship. About one-half of the students too