Four out of five doctors surveyed said they let drug and device makers buy them food and drinks despite recent efforts to tighten ethics rules and avoid conflicts of interest.
The national survey also found that family doctors were more likely to meet with industry sales representatives and that cardiologists were more likely to pocket fees than other specialists.
The study is the first to document the extent of the relationships between doctors and sales reps since 2002 when a leading industry group adopted voluntary guidelines discouraging companies from giving doctors gifts or tickets. In general, researchers found hardly anything had changed since previous studies a couple years earlier.
Consumer advocates say this is proof the new rules aren't working.
"These findings are fairly disturbing. There appears to be no dialing back at all on these relationships," said Merrill Goozner of the Center for Science in the Public Interest.
The survey, published in today's New England Journal of Medicine, was done by researchers from Massachusetts General Hospital, Yale University and the University of Melbourne in Australia.
Researchers mailed questionnaires to 3,167 doctors around the nation in 2003 and 2004 and 1,662 replied. They included anesthesiologists, cardiologists, family doctors, surgeons, internists and pediatricians with experience ranging from less than 10 years to over 30 years. Half were in private group practices and the rest worked in hospitals and medical schools.
Responses were anonymous. About 95 percent said they had contact with drug or device companies.
Other findings:83 percent received food and drinks.
78 percent accepted free drug samples.
35 percent were reimbursed for costs associated with professional meetings.
28 percent pocketed consulting or lecture fees.
7 percent took free tickets to games and other events.
The extent of the interactions varied by specialty and sales reps tend to target doctors with the most influence. For example, cardiologists were more than twice as likely than family doctors to receive fees. Doctors in private practice were six times more likely to get free samples and three times more likely to get gifts than those at hospitals. Family doctors met with sales reps far more often than their counterparts — about 16 meetings a month.
Doctors need to "supervise themselves and set stricter standards on what is appropriate and acceptable behavior," said one of the authors, Dr. David Blumenthal, head of the Institute for Health Policy at Massachusetts General Hospital.
The study was funded by the New York-based Institute on Medicine as a Profession. None of the authors reported conflicts of interest related to the study.