Ethical aspects of physicians interactions with the pharmaceutical industry

The main aim of this thesis was to ascertain awareness among Fellows and trainees of a set of ethical Guidelines, developed by members of the Royal Australasian College of Physicians (RACP) to specifically address interactions of physicians with the pharmaceutical industry. A mixed methods approach was used to answer a set of research questions and to understand the complexity of reasons that determine the propensity of physicians to interact with the pharmaceutical industry. Fellows and trainees were invited to attend focus group discussions and in-depth interviews held in Australia and New Zealand. Most of the participants were aware of the Guidelines and acknowledged that Guidelines were important to have in a professional context. Views of participants differed as to the level of compliance which was thought to be necessary to achieve transparency and in relation to the extent to which their prescribing patterns were influenced by industry interaction. A national survey was developed incorporating views and opinions expressed by participants from the qualitative study. The response rate was 25%. The level of awareness of Guidelines among Fellows was very high (84%) and much lower among trainees (46%). This study was unable to show an association between awareness of the Guidelines and propensity of physicians to interact with industry. A factor analysis demonstrated high scores for activities which involved physicians passively interacting with industry. There were some differences shown in relation to the demographic profiles of physicians.This thesis adds new knowledge with regard to the effectiveness of ethical guidelines and whether awareness of guidelines has the potential to influence physicians decision making about interacting with the pharmaceutical industry. Awareness of the Guidelines alone was not sufficient to constructively influence physicians interaction with industry. Other strategies such as information from independent sources or greater opportunities for discussion and debate need to be investigated and measured for their potential impact. There needs to be a new approach to the ethical aspects of physician relationships with the pharmaceutical industry