Background: Little is known about patients' awareness of and attitudes about gifts to physicians from pharmaceutical companies.
Methods: During a 7-week period in summer 1994, we surveyed adults (18 years of age and older) in the waiting rooms of two family practice centers in central Missouri. Four-hundred eighty-six adults (83 percent participation rate) responded to a self-administered questionnaire that assessed awareness of and attitudes about representative gifts.
Results: Rates of awareness of specific gifts were 87.0 percent for free drug samples, 55.3 percent for ballpoint pens, 34.6 percent for medical books, 28.6 percent for baby formula, 22.4 percent for dinner at a restaurant, and 13.8 percent for a coffee maker. Of the 486 respondents, the following percentages were reported that "it is not all right" for physicians to accept specific gifts: dinner at a restaurant, 48.4 percent; baby formula, 44.2 percent; coffee maker, 40.7 percent; ballpoint pens, 17.5 percent; medical books, 16.9 percent; drug samples, 7.6 percent. In addition, 32.5 percent did not approve of their physicians accepting payment by a pharmaceutical company of medical conference expenses and from 28.0 percent to 43.4 percent disapproved of their physicians attending specific social events sponsored by pharmaceutical companies at a medical conference. Seventy percent of the subjects believed that gifts sometimes or frequently influence a physician's prescribing of medication; 64.0 percent believed that gifts to physicians increase the cost of medication. Beliefs that gifts influence prescribing behavior and beliefs that gifts increase medication costs were strongly associated with disapproval of each gift except for drug samples.
Conclusions: Respondents distinguished between particular gifts; approval rates were high for gifts generally considered to be trivial or that have potential value to patient care; disapproval rates were relatively high for gifts that have some monetary value but have little or no benefit for patients. Opinions about gifts were related to perceptions of their effects on prescribing behavior and costs.