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Ann Thorac Surg 2007;84:1077-1084
© 2007 The Society of Thoracic Surgeons

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Ethics in Cardiothoracic Surgery

Politely Refuse the Pen and Note Pad: Gifts From Industry to Physicians Harm Patients

^a Arizona Bioethics Program, University of Arizona, Tucson, Arizona
^b Department of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
^c Department of Surgery and the Institute of Human Values in Health Care, Medical University of South Carolina, Charleston, South Carolina

^_* Address correspondence to Dr Sade, Department of Surgery, 96 Jonathan Lucas St, Ste 409, PO Box 250612, Charleston, SC 29425 (Email: sader@musc.edu).

Presented at the Fifty-third Annual Meeting of the Southern Thoracic Surgical Association, Tucson, AZ, Nov 8–11, 2006.

The first 300 words of the full text of this article appear below.

	Introduction

 
Robert M. Sade, MD
Drug companies use many methods to bring their products to the attention of physicians. Most of us are familiar with contacts between drug company representatives, formerly called detail men, stemming from the time when, as medical students, we were beneficiaries of the Eli Lilly Company’s largesse: doctor’s bag, stethoscope, hammer, and tuning fork. Since then, most of us have been offered many other small (sometimes big) gifts that are intended to gain our attention. Decades ago, no one saw much of a problem with this practice; rather, most saw it as a harmless, friendly gesture that led to valuable educational exchanges between detail men and physicians. In recent years, however, there has been a crescendo of warnings that such gifts are not harmless but endanger patients by binding us to the giver of the gift through the elemental human response to gifts: reciprocity, the need to give something back to the giver. Some worry that the impulse of reciprocity may lead us to prescribe products that are not quite right for a particular patient or prescribe an expensive drug in place of an effective drug that is much less expensive. Do we unwittingly endanger our patients by accepting gifts?

	The Case of the Detailed Surgeon

 
Dr John DeNile is always happy to see Cindy, a representative of the NovoCefalo Company, in his office. She is an articulate and attractive brunette who visits Dr DeNile once every month or two with information that has recently become available about the various drugs produced by NovoCefalo. She always brings with her ballpoint pens, note pads, Post-it pads, and other small gifts (most bearing the company’s logo), which Dr DeNile finds useful in his office. On this particular visit, Cindy provides Dr DeNile with information about NovoCefalo’s fourth generation cephalosporin, Cefprophylax. The antibiotic is new, but the United States (US) . . . [Full Text of this Article]