Relationships between health professionals and industry

The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.

Editor, – In a recent article (Aust Prescr 2007;30:150-3), Professor Paul Komesaroff mentions the Pharmaceutical Society of Australia's policy on gifts from pharmaceutical companies. The Society (PSA) also has a more comprehensive document entitled 'Guidelines for pharmacists' relationship with the pharmaceutical industry' which covers a broad range of issues including the promotion of healthcare products, conduct of meetings with medical representatives, gifts and inducements, loyalty schemes and support of educational activities.

While access to the guidelines is restricted to members of the PSA, we would be very happy to share the document with the author or other potential writers and researchers in this field.

Kerry Deans
Chief Executive Officer
Pharmaceutical Society of Australia
Canberra

(Editorial note: Ms Deans is no longer with the PSA)

Editor, – I refer to Professor Komesaroff's article (Aust Prescr 2007;30:150-3) whereby he understandably expresses concern about the influence that the pharmaceutical industry potentially exerts over prescribing clinicians. It must however be stated that few practising clinicians owe their livelihood to any one pharmaceutical company or product. This is in stark contrast to the involvement of other third party providers that exist within the healthcare system. The obvious example that comes to mind is medical practitioners whose work is predominately or entirely devoted to providing medicolegal reports for insurance companies. In this situation, there is more than a pharmaceutical company notepad, biro, or dinner on the line. Despite all this, it would seem evident that the majority of medical practitioners do practise ethically and appropriately.

Other circumstances involving third party healthcare stakeholders may have the potential to compromise a doctor's livelihood while raising considerable concern about the possible adverse impact on medical ethics and patient care. Recently, I heard of a situation where a young medical specialist who has a rather large practice and hires consulting rooms from a well-known private hospital, was told by hospital management that if he did not admit more inpatients, he would be told to vacate the consulting rooms on short notice, and this would be 'a pure business decision'. Seemingly, the conduct of pharmaceutical companies would appear to be just one dimension of potentially scurrilous interference in medical management.

Ian Katz
Consultant psychiatrist
Caulfield, Vic.

Professor Komesaroff, author of the article, comments:

This letter makes a single, but important, point that the influence of the 'for profit' sector is not limited to the pharmaceutical industry. While this does not reflect on any of the specific content of my article, it is nonetheless worth drawing attention to the fact that many of the arguments and concerns do apply more widely to include other influences such as those from the biotechnology industry, the private healthcare industry and the contract research organisation sector.