title: Pharmaceutical industry gifts to physicians: patient beliefs and trust in physicians and the health care system.
abstract: BACKGROUND
  Pharmaceutical industry gifts to physicians are common and influence physician behavior. Little is known about patient beliefs about the prevalence of these gifts and how these beliefs may influence trust in physicians and the health care system.
  
  
  OBJECTIVE
  To measure patient perceptions about the prevalence of industry gifts and their relationship to trust in doctors and the health care system.
  
  
  METHODS
  Cross sectional random digit dial telephone survey.
  
  
  METHODS
  African-American and White adults in 40 large metropolitan areas.
  
  
  METHODS
  Respondents' beliefs about whether their physician and physicians in general receive industry gifts, physician trust, and health care system distrust.
  
  
  RESULTS
  Overall, 55% of respondents believe their physician receives gifts, and 34% believe almost all doctors receive gifts. Respondents of higher socioeconomic status (income, education) and younger age were more likely to believe their physician receives gifts. In multivariate analyses, those that believe their personal physician receives gifts were more likely to report low physician trust (OR 2.26, 95% CI 1.56-3.30) and high health care system distrust (OR 2.03, 95% CI 1.49-2.77). Similarly, those that believe almost all doctors accept gifts were more likely to report low physician trust (OR 1.69, 95% CI 1.25-2.29) and high health care system distrust (OR 2.57, 95% CI 1.82-3.62).
  
  
  CONCLUSIONS
  Patients perceive physician-industry gift relationships as common. Patients that believe gift relationships exist report lower levels of physician trust and higher rates of health care system distrust. Greater efforts to limit industry-physician gifts could have positive effects beyond reducing influences on physician behavior.
authors.affiliation: Department of Medicine, University of Pennsylvania, 3641 Locust Walk - Room 407, Philadelphia, PA 19104, USA. dgrande@wharton.upenn.edu
authors.forename: David
authors.initials: D
authors.lastname: Grande
authors.forename: Judy A
authors.initials: JA
authors.lastname: Shea
authors.forename: Katrina
authors.initials: K
authors.lastname: Armstrong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003469:Culture; D004345:Drug Industry / Q000592:standards*; D005260:Female; D037921:Gift Giving; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients; D004364:Pharmaceutical Preparations / Q000191:economics / Q000600:supply & distribution; D010817:Physician-Patient Relations; D010820:Physicians / Q000592:standards; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D035502:Trust; D055815:Young Adult
chemical_list: D004364:Pharmaceutical Preparations