Physician Perspectives on Pharmaceutical Promotion

From the JAMA Health Forum

By Helen Mooney; Kirsten Austad; Eric G. Campbell; Jerry Avorn, MD; Zhigang Lu; Aaron S. Kesselheim, MD, JD, MPH

SUMMARY: This JAMA Health Forum survey study examines how medical students' and residents' interactions with and attitudes toward the pharmaceutical industry changed over a 13-year period from 2011 to 2024. The research team — which includes Avorn, a founding figure in academic detailing research — surveyed the same population of trainees at both time points, supplementing contact information with publicly available email addresses to maximize follow-up. Pharmaceutical manufacturers spend over $35 billion per year marketing drugs, often directly to health care professionals, making trainee attitudes toward this marketing a critical indicator of the medical profession's long-term resistance to or acceptance of industry influence. The study design — a repeat survey of the same trainee cohort — allows for direct comparison of attitudinal change over time, providing evidence on whether medical education efforts to address industry relationships have had measurable effect.

BACKGROUND: Pharmaceutical manufacturers spend over $35 billion per year marketing drugs directly to health care professionals. In 2011, the research team surveyed medical students and residents about their interactions with and attitudes toward the pharmaceutical industry.

KEY FINDINGS: Of the 3,495 students and 1,815 residents surveyed in 2011, 1,610 medical students (49%) and 739 residents (43%) responded. In 2024, the team resurveyed the same cohort, supplementing contact details with publicly available email addresses to investigate changes in attitudes over 13 years.

IMPLICATIONS: Longitudinal data on trainee attitudes toward pharmaceutical promotion can inform efforts to strengthen medical education policies on industry relationships.