It is no secret that the federal government is very interested in the connection between gifts and other remuneration from drug and device manufacturers and physician decision-making when it comes to ordering those items. At least one Senator has gone so far as to introduce legislation which would require disclosure of these financial relationships. According to a recent article in the Baltimore Sun, some doctors are voluntarily refusing to accept gifts from industry.
While the legal ramifications of accepting remuneration from industry for goods and services covered by federal payor programs are quite severe under the federal anti-kickback statute, the line between what will be tolerated (e.g., low cost meals coupled with an educational program) and what will land a physician in hot water has become blurred. This confusion is likley due, at least in part, to the pharmaceutical and device industries' efforts to self-police through their own codes of conduct which permit conduct not expressly permitted under the anti-kickback statute.
As the Baltimore Sun article illustrates, some doctors are beginning to recognize that even if a compensation arrangement with industry is permissible -- or at least tolerated -- under federal law, there may still be negative consequences to particpating. In particular, the public may be left with the perception -- right or wrong -- that a doctor with industry ties has a conflict of interest. The legal implications are no doubt important, but doctors should remember that how something will look on the front page of the newspaper may be just as important.