The Relationship Between Physicians in Training and Pharmaceutical Companies: A Time for Guidelines?

Altruism or competitive gain in the i marketplace? Pharmaceutical companies have traditionally invested in the education of future practitioners, claiming a commitment to the expansion of medical knowledge. Although this objective is undoubtedly genuine, it would be naive to assume that gaining an edge in the marketplace is not also a motivating force. Both goals are likely operational in the strategic planning of pharmaceutical companies. It would be unjustified to suggest that the relationships between physicians in training and pharmaceutical companies be eliminated. However, they should be examined. Indeed, the time has come to establish guidelines to protect the social contract that physicians have with their patients. In his recent Shattuck lecture, Relman 1 reminded us that physicians are "parties to a social contract"; that they practice in a profession relatively protected from interference (competition) with others; that the training, information, and technology needed to practice are provided by public