Doctors and Drug Companies Still Cozy after All These Years 英文参考文献.docVIP

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Doctors and Drug Companies Still Cozy after All These Years 英文参考文献.doc

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Doctors and Drug Companies Still Cozy after All These Years 英文参考文献

Perspective DoctorsandDrugCompanies:StillCozyafterAllThese Years DavidHenry1,2,3 * 1InstituteforClinicalEvaluativeSciences,Toronto,Ontario,Canada,2DepartmentofMedicine,UniversityofToronto,Toronto,Ontario,Canada,3SchoolofMedicineand PublicHealth,UniversityofNewcastle,Callaghan,NewSouthWales,Australia The relationships between doctors and drug companies are controversial and havelongbeenscrutinizedbyresearchers, ethicists, professional bodies, and legisla- tors[1].Inrecentyears,growingconcerns about these ties, and allegations of some corruptpractices,haveengenderedalarge amount of coverage in the media and professionaljournals[2–4]. who have questioned the relationships between doctors and drug companies. They have also been the main target of the legislative responses in the US and Australia. But, open-ended activities such as‘‘unrestricted’’researchgrants,‘‘educa- tional’’ grants, membership in speakers’ bureaus and advisory panels, consultan- cies,andstock-holdingcouldbeofgreater concern, through an insidious blurring of professional boundaries and obligations [10]. There is evidence that these types of ties are common among specialist physicians[11]. This Perspective discusses the fol- lowing study published in PLoS Medicine: Spurling GK, Mansfield PR, Mon- tgomery BD, Lexchin J, Doust J, etal.(2010)InformationfromPhar- maceutical Companies and the Quality, Quantity, and Cost of Phy- sicians’ Prescribing: A Systematic Review.PLoSMed7(10):e1000352. doi:10.1371/journal.pmed.1000352. In my experience, the main concerns about close ties between companies and doctors are that 1) they lead to inappro- priateprescribingthatcanharmpatients; 2)theycreatedividedloyaltiesfordoctors between the health system, their patients, andmanufacturingcompanies,whichisa conflictofcommitmentaswellasaconflict of interest; 3) they lead to use of unnec- essary and expensive medications with consequent costs falling on health care systems and patients; 4) they may lead to medicali