Katz et al. state that “when a gift or gesture of any size is bestowed, it imposes on the recipient a sense of indebtedness” (41). They apply this idea to physicians and sales representatives, arguing that a sense of indebtedness forces physicians to reciprocate, even for small gifts. This then of course leads physicians to make decisions that may not be in the best interest of their patients.
The aforementioned connection that Katz et al. make seems to me to be highly speculative. Of course, I do not want to argue against the idea that many people experience the obligatory nag of reciprocity when a gift is bestowed. However, I do not think that every time a gift is given, a person always feels the need to compliment their bestower. In fact, I would argue that many people only feel the need to reciprocate when they are involved in a personal relationship with the bestower, or were somehow emotionally affected by the bestowal. In many professional relationships, however, this is not the case.
Katz et al. might respond to this criticism, since they state that “…the act of dining helps to foster a cozier working relationships that might help break down professional barriers between physicians and sales representatives” (41). But I fail to see how a mere dinner invitation would necessarily cause the physician to feel obligated to return the favor. Unless the sales representative is someone who the physician knows personally and/or has a non-professional relationship with, it does not seem that the physician would be so strongly affected by dinner that she simply had to repay the representative. With this said, if there is a correlation between physicians, sales representatives, and gifts, I think that it would be more along the lines of what Loewenstein and Dana argue regarding bias.