Michael Oldani highlights in his article, “Thick Prescriptions”, that physicians are indoctrinated into the culture of gifting during their initial training programs as residents. Physicians may claim that their personal and professional integrity remains uncompromised, but for those familiar with the sociological studies showing the effects of even small gifts on physician prescription writing practices, the gift giving culture becomes an ethical concern. Attempts to place restrictions on gifting are often viewed with hostility as physicians feel that they cannot be bought, and that accepting small gifts from pharmaceutical companies as one of the “perks” of the job, or compensation for meeting with drug representatives.
However, the acceptance of gifting should not be taken as a foregone conclusion just because it has become common practice between physicians and pharmaceutical companies. Since gifts often have an effect on scripting writing practices, the key to curbing this practice has to start from a grassroots level. We need to alter the current indoctrination into a gifting culture and create regulations whereby pharmaceutical companies are not permitted to offer any kinds of “gifts” to physicians starting with residents.
We need to begin to break the cycle of receiving gifts from pharmaceutical companies has become routine and normal within medical practice. Established physicians may be reluctant to turn down gifts, but this should not preclude the possibility of establishing a new routine and norm within up-and-coming medical professionals, highlighting the negative effects of accepting gifts. In essence, the key to breaking the cycle of gifting seems to be putting an end to the indoctrination into the culture of gift giving, and the best way to do this is to start with residents, till, hopefully, the practice eventually dies out.