I think that in the example mentioned, it does make sense that the wife is not paid for unless she had a real contribution to the product or business being done. The overall idea of the dinner was to discuss and talk about the business and not an opportunity for someone outside of this to get a free meal. The idea of thanking someone for what they have done by treating them to a meal is definitely a common practice but it seems that the scenario described is taking advantage of it a little. In order to improve this kind of situation, it should be made clear who the dinner is for and who is involved in the process. It seems that bringing an outside person unannounced creates more problems and seems to be rude to the people paying for it. I have personally never run into this issue at all the business dinners that I have been part of but can assume it happens regularly, especially when dealing with more executive members.

Hi,

I agree with the fact that it seems rude, if the physician brings his/her spouse, to the dinner then the physician has to pay for the spouse's meal. However, from a logical and ethical point of view, the AdvaMed guideline about this situation is appropriate. The relationship between the physician and the medical device company member shouldn't be anything more than professional. Therefore, during business dinners, not accompanying the spouse would be an ideal scenario. 

I think, allowing giving less than $100 gifts is a good approach to ensure that physicians never make biased decisions about medical products due to their personal benefits. Presenting a souvenir for less than $100 is actually a way of appreciating the effort and hard work of the doctor, that's less likely to be bribery.

Hi,

I agree with the fact that it seems rude, if the physician brings his/her spouse, to the dinner then the physician has to pay for the spouse's meal. However, from a logical and ethical point of view, the AdvaMed guideline about this situation is appropriate. The relationship between the physician and the medical device company member shouldn't be anything more than professional. Therefore, during business dinners, not accompanying the spouse would be an ideal scenario. 

I think, allowing giving less than $100 gifts is a good approach to ensure that physicians never make biased decisions about medical products due to their personal benefits. Presenting a souvenir for less than $100 is actually a way of appreciating the effort and hard work of the doctor, that's less likely to be bribery.

I definitely think that it is a little too restricted, but usually a lot of the time doctors do not even accept any gifts or they pay it forward. Doctors are a lot more laid back in my opinion when it comes to things like this and they surely appreciate the smaller things or more modest gifts or gestures. For example, at my job we have tried to give them Christmas gives or even Valentine’s Day candies. They will usually accept them and he very grateful for them, but sometimes they give them away. I do think that in the situation you mention should be known to the doctor and spouse before the dinner so that it wouldn’t be awkward.

I have actually worked for companies where we could not gift over $25. I actually think the $100 limit is reasonable to be honest. After all we have rules and policies to follow when we are part of companies and organizations and the fact that a doctor brings his wife has nothing to do with your responsibility. Of course it may seem a little inconsiderate to not pay for the wife, but business is business. I think if a person genuinely wants to help you achieve your goals they will no matter what you can or can't do for them monetarily. I believe that there is nothing wrong with showing appreciation in moderation, and I think the limitations set forth on gifts are for great reasons. 

I understand what you are saying but I do understand the ethical boundaries that need to be placed upon this type of relationship. As in registered behavior therapists, I am also not allowed to receive gifts from my patients or clients parents. It establishes a boundary of professional and personal so those lines are never blurred. These regulations are placed to protect not only the patients but the physician as well and so that these transactions can never be brought into question if something does happen. These restrictions are critical and important in this field and I do not believe that it is too much but absolutely necessary. I think a great example to think of these terms are in the case of lawsuits both sides are protected because there were no blurred lines in the relationship in the first place.

I believe in some instances it is entirely too strict and there should be some leniency. Of course, I think anything extensive or lavish should be minimal, but it should also be at the discretion of the patient. The doctor may have saved their life or a loved one’s life and some people's way of saying thank you is to give a gift. After both of my deliveries, we gifted the staff that were on duty with gift cards and dinner. I agree in some instances it may seem like bribery, I have even noticed cases where people were bribing doctors for different services and medications and the doctors and physicians. But I think the example you mentioned is a great way of compensation or showing thanks. I think these situations should be and can be approached differently so people don’t feel taken advantage of but you can also be able to show your appreciation.

I think this is perfectly ok.  Since it is a set rule, there should be no awkwardness.  If everyone is on the same page then it won't be a problem.  I get it.  Giving to many gifts can be a way of bribery.  I appreciate the rules and think that it prevents certain companies from taking advantage of or preventing other companies from having chances.  As long as everyone is on the same page, then its a fair playing field.

Although a scenario like this may appear to be too restrictive, I believe that it is best to maintain these strict practices to ensure that ethics are not being compromised. As mentioned by others, the Sunshine Act was established to restrict the giving of gifts between physicians and medical devices or pharmaceutical companies. In order to avoid these types of awkward situations it is best to ensure that both parties understand the different regulations put in place and when/how a dinner can be set up that abides with these laws. It should be made clear prior to the dinner how strict these rules are to ensure that neither side is blindsided or put into an awkward situation. Many companies now have provided their employees with training to ensure that they are not offering gifts that are outside of what is legal and do not result in a conflict of interest. Additionally, most companies urge their employees to not accept any gifts from other companies or physicians. 

While these rules or regulations may seem like they are too restrictive, they are necessary for the integrity of the pharmaceutical/medical device industry. While it is appropriate to pay for a physician's dinner when taking them out for dinner to discuss business, certain gifts are not necessary. These unnecessary gifts can be seen as bribes, which can ultimately have detrimental effects on the clinical trial/approval process. I believe it is important for employees to realize why they are giving the gifts. If it is to influence or persuade someone, it is probably better to hold off, especially because bribery can be brought to court.

No, I think this is all there for a reason. There is a reason why the laws were passed in the first place. You gain someone's favor by spending a lot of money on them. As for the awkward situation, there is not much you can do about it. You should try to face it head on. Imagine if they were trying to get the doctor's approval on something bad. Having a limit, keeps everyone on the same playing field. 

This is a very good question. In my opinion, if you invite a physician to a dinner to talk about the product you can promote and they bring their spouse to the dinner, it is very disrespectful to only pay for the doctor's dinner and ask them to pay for the spouse's dinners . Usually, these situations do not happen often, because in most cases physicians go to this type of meeting by themselves, they do not bring their spouses. Also, one way is to notify the physician to come to the appointment alone. But in other words, if this situation can happen, in my opinion it is okay for them to pay for the doctor and their spouse's dinner. As for the $100 gift, it's fine to give the doctor two to three items a year, but not too often.

The ethical guidelines governing gifts and incentives in the medical industry, particularly the $100 cap on gifts to physicians and the prohibition of covering expenses for a physician's spouse, may initially appear overly restrictive. However, these rules serve a vital purpose in maintaining the highest ethical standards and preventing potential conflicts of interest. The objective is to ensure that medical decisions are guided solely by patient needs and evidence-based practices, not influenced by personal gain. By setting these boundaries, the healthcare industry upholds transparency and trust, crucial in a field where patient welfare is paramount. These guidelines are not intended to undermine professional relationships or undervalue the contributions of physicians. Instead, they aim to preserve the integrity of these relationships and ensure independence in medical judgment. Alternative forms of appreciation, like professional development opportunities and public recognition, can be explored to acknowledge a physician's contributions while adhering to these ethical standards. In essence, these regulations, though seemingly stringent, are fundamental in safeguarding the credibility and ethical integrity of the healthcare sector.

Hello,

Your observation raises a valid point about the restrictions on gifts and expenses in the context of collaborations between companies and physicians. The limitations are in place to maintain ethical standards, prevent conflicts of interest, and ensure transparency in healthcare relationships. While these regulations aim to uphold integrity, they can indeed create situations that feel restricted, especially in social settings like dinners involving spouses.

One way to navigate these situations is by focusing on alternative ways to express appreciation and foster positive relationships. Rather than covering the expenses directly, consider sending a thoughtful gift to the physician's home or office as a gesture of gratitude. This could be something related to health or a personalized item that aligns with their interests.

Another approach is to host events where both professional and personal aspects can be acknowledged. For instance, organizing team-building activities, workshops, or educational events that include spouses can be a way to foster a positive environment without breaching compliance regulations. Engaging in open communication with the physicians involved in the project is crucial. Discussing the restrictions and finding mutually agreeable ways to express appreciation ensures that everyone is on the same page and comfortable with the arrangements.

Hi Roberto,

I agree with you that these situations can feel awkward especially when the intent is simply to show professional gratitude. One way to address this awkwardness might be to have clear communication up front. I would have had to let the physician know about the limitations beforehand to avoid any misunderstandings. Another way to approach this is companies could explore different ways t show appreciation such as sending small tokens of thanks. While the restrictions feel limiting, it is important to acknowledge that they are in place to ensure ethical boundaries are maintained and to prevent any undue influence on physicians' decisions. These policies aim to avoid creating any bias or conflict of interest.