I feel that the restrictions are needed since there is no need for the doctor to get his wife for a business dinner. More importantly this is needed because if there are no restrictions huge companies may give lot of gifts to the doctor and imbibe greed in the doctor which directly results in tampering the outcome of the clinical trials. Keeping a restriction helps promote fair business and maintain fair outcomes during the clinical trials
No there is nothing that should be done about this. General attitude being conveyed is that gifts are not to be used to unduly influence healthcare providers in their decisions. Regarding the lack of inclusion of spouses meals, i think it serves as a good reminders for participant how careful they should be in staying away from even a hint of behavior reminiscent of bribery.
It may seem restricted, however, I would like to offer a different perspective towards these restrictions. Let's say there are two companies who are fighting for one physician to consult with. Company A is a gigantic firm with a lot of resources and connection whereas company B is a startup company which does not have a lot of resources. The restrictions layout by the laws helps create a fairer equal playing field for both the companies. The physician is able to choose a project solely on the idea, not other benefits not associated with the health care fields. Which translates into a better outcome of the study which will help the general public overall.
Actually, I do feel like NOT paying for the physician's spouse, if the vendor is taking the physician out for dinner does rank a "petty" in my opinion. However, I don't believe that the rule will change, due to the abuse of referrals for pay, before the federal government begin cracking down. Health industry and medical device vendors do have an option treating a clinical department or office to a luncheon, especially if it is combined with education. As much as feel for the spouse who has to go dutch, it does not change the fact that the kickback system in healthcare is unethical and contributes to inequities in medical treatment.
Having this rule is really helpful, as the physician will not make the judgment about the device according to what the company has offered from gifts, so the process will be fair to all companies if it was a big company or just a start up. On the other hand, Having the spouse to a business meeting does not happen that often, and also everyone on the market now knows about this rule, so it will not cause a problem.
I also found these restrictions to be quite ridiculous, especially not being able to pay for the physicians spouse. However, I do understand why these regulations are in place and what they are preventing. As Professor Simon had mentioned in the video lecture, if the person selling to the physician were to shower them in gifts, it may persuade them to buy that product over another with no consideration of the patient and what they actually need. This is a rough guideline, although the line has to be drawn somewhere. And if this were previously abused in the past, as Professor Simon spoke to the "old days," I understand why the restrictions would be much tighter now. Maybe one possible way to avoid the awkwardness of not being able to pay for the physicians spouse is to let them know prior to the dinner that you kindly request they do not bring anyone, possibly even blame it on some sort of confidentiality? Unsure if this is practical advice, as I've never been in the situation and am not terribly aware of the social norms that go along with these sort of business exchanges, but it is only a suggestion.
Even though this is an awkward situation, it isn’t too restricting because this is a business dinner after all. Bringing a spouse to the business dinner is unnecessary, and if it does happen, then the physician should be in charge of paying for the spouse. The guidelines are preventing the act of taking advantage in these situations and making it awkward for the other person. If the dinner does not involve business relations, and the two families are going out for dinner together as friends, then these guidelines don’t count. If in the other case where the physician allows the person selling the product to pay for the spouses dinner, then it could potentially count as bribery. Everything that deals with the business should be benefitting both sides equally and legally.
I do believe these restrictions are necessary. As many have mentioned before, greed can become a problem and the money can maybe cloud the judgements of some. One thing that comes to mind is an article I read several years ago where they discussed how much these gifts to physicians had a role in the opioid epidemic in the US. Doctors were more prone to prescribe opioids because pharma companies had offered them a prize in return for using their drug. The rules present are necessary to prevent things from getting out of hand.
So funny enough my father is a physician and I have actually seen him uncomfortably try and manage around companies or people who don't entirely respect these restrictions. I think that these restrictions should not be lifted or changed; while it may seem impolite to not pay for a doctor and their partner's meal I think it would be far more damaging to due such and hurt both your own and the doctor's reputation. There is a thin line between a gift and a bribe, and to be safe I think it's easier to just function within the regulations and rules that currently exist.
Sunshine laws are regulations created to deal with these kinds of conflicts. In most basic, it requires business in multiple different industries and businesses, such as the health industry, to make their certain operations transparent and available to the public. Unfortunately, it is not a bulletproof system, but better than nothing, I guess. In terms of sunshine laws, physicians have to report gifts from drug and medical company representatives given to them. With this rule, legally, they can be a little more flexible. Simultaneously, for the educated, it is possible to research his or her own physician when the patient gets to be offered a drug that is not fairly known to find the real reason behind the prescription.
Interesting topic. I was not aware of such restrictions on physicians. I think the idea of these restrictions is to maintain a sense of integrity and professionalism in the medical field. Physicians are often directly responsible for the health and wellness of their patients. Gifts may have some appearance as bribery or influence on the physician. However, there are plenty of other fields that have a direct impact on people's health and wellness but do not have the same restrictioins.
Hello everyone,
As I was listening to this week's lecture, it called my attention the fact that companies can only give gifts of 100$ to the physicians and those gifts have to be related to health. Additionally, Dr. Simon mentioned that whenever these people go have dinner to discuss the project and the doctor brings his wife, you can't even pay for the meal of the physician's wife. Don't you think that this too restricted? Paying for someone else's meal is the least you can do when that person is helping achieve something important. What do you think about this? Is there anything that could be done in order to improve this kind of awkward situations?
Sincerely,
Roberto Pineda.
I think it is admirable to want to pay, but given the rules, I think it's best to leave it alone. If both parties know what is customary, it should alleviate the imposed awkward situation. Perhaps a kind gesture can be given once business ties are no more and some time has passed. I think there would have to be clearly defined relationships: business or personal. If it's still business-related, then gifts should not be given unless it falls into the $100 category. Although it is not practiced as often as it probably should be, a nice handwritten note might go a long way.
There was a time where pharmaceutical companies and medical device developers used to have lavish accounts and spending on physicians to be able to prescribe or use their products. Incentives included concert tickets, sporting events, lavish dinners, gift baskets, expensive merchandise, vacation getaways, etc. This is a similar phenomenon that was seen in the financial industry when headhunters used to acquire high net worth clients but this practice has since been done away with due to conflict of interest practices. You can easily see how far down the rabbit hole this can go and how the lines can be blurred when it comes to advocating for the medication or a device as opposed to bribery. These gifts do not always translate into the services you want and physicians are not contractually obligated to prescribe or recommend drugs or devices based on these gifts. So this was seen as problematic to the medical community it has since been outlawed but there was a time that this type of practice was very much a part of the main stream.
Hello everyone,
As I was listening to this week's lecture, it called my attention the fact that companies can only give gifts of 100$ to the physicians and those gifts have to be related to health. Additionally, Dr. Simon mentioned that whenever these people go have dinner to discuss the project and the doctor brings his wife, you can't even pay for the meal of the physician's wife. Don't you think that this too restricted? Paying for someone else's meal is the least you can do when that person is helping achieve something important. What do you think about this? Is there anything that could be done in order to improve this kind of awkward situations?
Sincerely,
Roberto Pineda.
Hi Roberto,
I think you pose an excellent question. In my opinion, it is a bit too restrictive, but I can also understand why it is necessary. I think that it's a good method to prevent bribery. At the same time, there are so many loops holes, such as having multiple physicians at dinner and tabbing the whole bill together, then you don't know who spent what on who. The best way to do this maybe loosens the standards a bit and have companies come up with their own policies within the constraint of the law.
I'd like to add that criteria for giving and receiving gifts often applies to both sides in a lot of company policies. Specifically, my company's policy is that I am not allowed to receive gifts of any kind, no matter how small. For example, if a vendor sends me flowers to wish me well after an illness for example, I am not allowed to accept them, even though there is clearly no intent of bribery.
As others have mentioned, these strict policies are crucial for companies to avoid lawsuits by eliminating even the appearance of any bribery occurring.
I like that your company has these restrictions. It is my belief that accepting gifts could be detrimental to the process. People are swayed by the pretty gifts versus the facts and foundation. Which in a way is bribery in itself it takes out the ability to be unbias in the situation.
