Boston, MA - Cardiologists are more than twice as likely as family practitioners to receive payments from industry for consulting, speaking, serving on boards, or enrolling patients in clinical trials and were also significantly more likely than pediatricians, anesthesiologists, or surgeons to receive these types of payments [1]. Authors of a new survey speculate that cardiologists, more so than the other groups studied, may be targeted as thought leaders and because their prescribing patterns influence those of nonspecialists.

Results from the survey, which examined acceptance of gifts, samples, reimbursements, or payments by anesthesiologists, cardiologists, family practitioners, general surgeons, internists, and pediatricians, appear in the April 26, 2007 issue of the New England Journal of Medicine.

As Dr Eric G Campbell (Institute for Health Policy, Massachusetts General Hospital, and Harvard Medical School, Boston, MA) et al report, of 3504 doctors surveyed in 2003-2004, 1662 completed the questionnaire (52%), with cardiologists having the lowest response rate of all physician types surveyed, at 42%. For the whole group, 83% of respondents reported receiving food or beverages in the workplace; 78% said they'd accepted drug samples; 35% declared receiving reimbursements for meeting expenses or admission to CME sessions; and 28% said they'd received payments for various services. But cardiologists in particular were more likely to have accepted samples, gifts, or payments than their colleagues in some or all other fields; by contrast, anesthesiologists were consistently less likely to receive or accept industry benefits.

The finding speaks to the "peer influence" cardiologists hold. "Our findings suggest that industry may focus marketing efforts on physicians who are perceived as influencing the prescribing behaviors of other physicians," Campbell and colleagues observe. Cardiologists, they write, have "prescribing patterns as specialists and opinion leaders [that] are thought to influence the prescribing patterns of nonspecialists."

Campbell et al also note that across the medical fields they surveyed, physicians working in smaller group or solo practices were also significantly more likely to receive industry favors or compensation in some form than were physicians working in hospitals or clinics, where there may be policies restricting physician-industry relationships or drug formularies or agreements that restrict drug choices.

Further research should address the risks, benefits, or overall appropriateness of relationships between different specialist groups and drug-, device-, and medically related industries, the authors conclude.