製薬会社からの贈答品が空っぽの箱だったら？

　利益相反（conflict of interests ; COIs)について、現状を知るのに、この３つの質問が役に立ちそうです。

1.What do physicians receive from industry?

2.How often do physicians meet with industry representatives?

3.What characteristics are associated with the frequency and nature of physician–industry relationships?

　「何を贈答されているの？」「どのくらいの頻度でMRと会っているの？」「MRとの接触頻度が高くて自然と感じている医療従事者の特徴は？」これは、”A National Survey of Physician–Industry Relationships”という論文からの抜き出しです。

　製薬会社からの贈答品が空っぽの箱だったら、医療行為は変わりますか？

A National Survey of Physician–Industry Relationships

N Engl J Med. 2007 Apr 26;356(17):1742-50.

　この報告では、以下のような結果が出ています。

・94%の医師が製薬会社との関係がある

・お食事のおつきあい(83%)、医薬品の試供(78%)、勉強会費用の援助(35%)、講演や臨床試験の援助(25%以上)

・循環器の医師は、家庭医の２倍以上の贈答

・しかし、家庭医family practitionersのような１人、２人、もしくは少人数で診療をしている場合は、MRとの面会頻度が高い。

BACKGROUND: Relationships between physicians and pharmaceutical, medical device, and other medically related industries have received considerable attention in recent years. We surveyed physicians to collect information about their financial associations with industry and the factors that predict those associations.

METHODS: We conducted a national survey of 3167 physicians in six specialties (anesthesiology, cardiology, family practice, general surgery, internal medicine, and pediatrics) in late 2003 and early 2004. The raw response rate for this probability sample was 52%, and the weighted response rate was 58%.

RESULTS: Most physicians (94%) reported some type of relationship with the pharmaceutical industry, and most of these relationships involved receiving food in the workplace (83%) or receiving drug samples (78%). More than one third of the respondents (35%) received reimbursement for costs associated with professional meetings or continuing medical education, and more than one quarter (28%) received payments for consulting, giving lectures, or enrolling patients in trials. Cardiologists were more than twice as likely as family practitioners to receive payments. Family practitioners met more frequently with industry representatives than did physicians in other specialties, and physicians in solo, two-person, or group practices met more frequently with industry representatives than did physicians practicing in hospitals and clinics.

CONCLUSIONS: The results of this national survey indicate that relationships between physicians and industry are common and underscore the variation among such relationships according to specialty, practice type, and professional activities.

（上の図：どんな贈答を受けているか？、下の図：MRとの関連が強い医師の特徴）

気づき）

　・製薬会社からの贈答品が、空っぽの箱だったら、あなたの医療行為は変わりますか？

　・まずは、職場や医局と話をしてみることかな

　・教育、心理的な側面も検討だ

これから）情報室会議、論文整理はPapersでいけるか？判断する