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Restricted Contact With Drug Company Representatives Influences Future Physicians

Kate Traynor

Restricting contact between medical residents and pharmaceutical company representatives could produce physicians who rely less than their colleagues do on industry-supplied information.

Researchers surveyed physicians who had trained at McMaster University in Ontario, Canada, where internal medicine residents have little contact with drug company representatives and physicians trained at the University of Toronto who had unlimited access to drug company representatives.1

The former McMaster residents were 56% less likely than the physicians who trained at the University of Toronto to say that industry-provided drug information "sometimes," "often," or "always" helped to guide practice decisions. Likewise, those former McMaster residents were 61% less likely to say that industry-provided drug information helped guide their practice decisions than were residents who trained at the school before the restricted-contact policy began in 1992.

The 1999 study involved 157 Toronto graduates and 42 McMaster graduates, 25 of whom had completed their training after the restricted-contact policy went into effect. Baseline characteristics among the three groups of former internal medicine residents were similar.

To gather the data, the research team devised a survey designed to gauge physicians’ contact with and attitudes toward pharmaceutical company representatives. The survey relied on the physicians’ ability to remember their interactions with industry representatives during training. The survey also asked physicians how often they accepted gifts, honoraria, or consulting fees from drug companies or attended industry-sponsored social events.

Restriction of the residents’ contact with pharmaceutical company representatives did not later affect the physicians’ willingness to meet in their office with representatives. Eighty-eight percent of the physicians in each group reported meeting in their office with pharmaceutical company representatives at least once in the year before the survey.

Residents who had participated in the greatest number of industry-sponsored rounds during residency training were less likely than colleagues to later report conducting office visits with drug-industry representatives—a finding that the research team called unexpected.

Physicians who reported the greatest frequency of contact with industry representatives during training were more than seven times as likely as physicians having the least frequent contact to regard industry-provided drug information as helpful.

The McMaster graduates whose industry interactions were restricted during training reported fewer current contacts with drug company representatives than did Toronto graduates. There was no statistical difference between the frequency of current contacts of the two groups of former McMaster residents.

1. McCormick BB, Tomlinson G, Brill-Edwards P et al. Effect of restricting contact between pharmaceutical company representatives and internal medicine residents on posttraining attitudes and behavior. JAMA. 2001; 286:1994-9.