An intellectual virtue "vaccination" for physician-pharmaceutical industry interactions

Abstract

The pharmaceutical industry's wide range of interactions with physicians, trainees, and other medical professionals--interactions that include information transfer and financial incentives--has been the source of undue influences, especially on physicians' prescription behavior. Current literature has mainly been focused on the financial element of these influences, and the problems in medical professional-pharmaceutical industry interactions are mainly viewed in terms of conflicts of interest. There is often the assumption that physicians are intellectually competent but biased because of financial incentives.The author rejects that assumption and proposes an alternative explanation for the observed influence of the pharmaceutical industry on physicians' behavior by emphasizing the importance of the information-transfer side of the interactions and maintaining that physicians and other medical professionals need certain intellectual virtues (i.e., competencies) to properly assess the information, which is often unreliable and biased. These virtues are necessary for the practice of modern medicine and include mindfulness, the ability to understand practical implications of newly found evidence, to consider alternative explanations of data, to recognize and correct errors, to decide on the best available evidence, and to tailor that to the needs and values of individual patients. On the basis of this view, the author recommends that the best solution for the observed problems in physician-pharmaceutical industry interactions is to "vaccinate" physicians and other medical professionals by increasing efforts to inculcate the necessary intellectual virtues early in medical education and fostering them throughout those individuals' professional lives.