Medical Education Community Lacks Proper Training on Physician-Pharmaceutical Company Interactions

Each year, pharmaceutical companies spend billions of dollars on marketing and outreach, and an overwhelming majority of those funds support promoting drugs to physicians and other medical professionals. Studies and literature show that these promotional activities effectively influence doctors some to most of the time, including affecting their prescribing actions and their decisions in stocking their pharmacies.

However, interactions between pharmaceutical companies and physicians often begin before the latter population even finishes medical school. Drug manufacturers sponsor meals and conferences for doctors-in-training, provide them with books and gifts, and even back scientific meetings that they attend. In one study, medical students reported an average of 10 to 11 contacts with pharmaceutical representatives each month. Plus, many medical school program directors allow these interactions to take place by providing opportunities for drug reps to give presentations to and meet with students. At the same time, the majority of physician trainees report being underprepared for such meetings and interactions and not fully aware of the guidelines governing them. According to one study, only about 23 percent of medical residents reported reading such guidelines.

About the Author:
Daniella Zipkin, M.D., researched medical student-pharmaceutical company relationships while working as an Attending Physician in the Department of Internal Medicine at the California Pacific Medical Center in San Francisco.


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As a teacher, investigator, and clinician, Dr. Daniella Zipkin works with physicians, staff, and medical residents to improve practices in evidence-based medicine and doctor-patient communication. Through research grants connected to her faculty position at Duke University in Durham, North Carolina, Dr. Zipkin studies the impact of communicating evidence to physicians in a collaborative atmosphere and to patients in a clinical setting. Dr. Daniella Zipkin currently serves as a Principal Investigator through a Duke Graduate Medical Education Innovation Grant on case-based teaching conferences in evidence-based medicine. She also leads a project through the Society of General Internal Medicine to create communication summaries for physicians to use with patients when explaining new clinical data. In conjunction with her academic role, Dr. Daniella Zipkin recently presented at several regional and national conferences. Dr. Zipkin developed and taught a workshop in evidence-based medicine at Children’s Hospital Los Angeles’ pediatric hospitalist program. She also served as a Workshop Leader at the Society of General Internal Medicine Annual Meeting in 2011 on two programs, titled “Is a picture worth a 1,000 words? Communicating Evidence to Patients” and “Beyond Critical Appraisal: Tips for Real World Application of Study Results.” Dr. Daniella Zipkin studied at The University of California, San Francisco (UCSF) School of Medicine and completed her residency in general internal medicine through New York University and Bellevue Hospital Center in New York. She started working as a clinician educator through a fellowship at UCSF in the Division of General Internal Medicine. Since then, Dr. Zipkin has held several faculty and research positions in evidence-based medicine at UCSF, the California Pacific Medical Center (CPMC) in San Francisco, and Duke University. In addition to her teaching background, Dr. Daniella Zipkin has served in several clinical settings as an Attending Physician at CPMC and as a Primary Care Internist at the Santa Cruz Medical Foundation in California. She is currently an Assistant Professor of Medicine at Duke University Medical Center in the Division of General Internal Medicine.