The medical profession and pharmaceutical industry have fallen short in reducing the influence of gifts on prescription practices through self-regulation. Government intervention is needed, but physicians also have an important role to play in cleansing the profession of commercial influence.

Concerns over the influence of pharmaceutical gifts on physicians have surged in recent years. This has prompted wide-ranging legislative proposals in numerous states and in the federal government, as well as stepped-up efforts at self-regulation by the pharmaceutical industry and the medical profession. Policy-makers face the decision of whether to defer to self-regulation or support government intervention. This commentary describes efforts at self-regulation by the pharmaceutical industry and the medical profession. The author examines and critiques the wide-ranging legislative strategies pursued to limit the influence of pharmaceutical gifts on physicians.

Key Recommendations:

• The government should assert its regulatory role by banning all gifts, rather than setting thresholds of permissibility.
• Disclosure has a place in academic medicine, but financial relationships with the sole purpose of influencing prescribing should be prohibited rather than disclosed.
• The medical profession needs to reclaim its professional independence from industry.

Governmental regulatory actions are needed to protect the medical profession from undue influence by pharmaceutical marketing practices. Self-regulation also remains important and is not at odds with government regulation. Physicians themselves will need to cleanse the profession of commercial influence in order to preserve the public trust.