(2004; 102 pages)
1.2 Studies of the prevalence of different attitudes to promotion (excluding direct-to-consumer advertising)
These are studies that simply assess percentages of people who report certain attitudes or beliefs about promotion. Some do start to explore differences within their samples, but this is not their main objective. Many of these studies look at the attitudes of medical students, doctors in training programmes, their trainers, or patients. Few studies look at practicing doctors, or at the public in general. Studies are often based at one or two institutions (usually in the USA and/or Canada), or are written questionnaires sent to directors of training programmes around the USA and/or Canada. Most studies focus on doctors in training or their trainers, examining and discussing what is an appropriate relationship between promotion and training.
Surveys of the prevalence of different attitudes include: Hodges4 who looked at psychiatry residents, interns and clerks in seven Canadian hospitals; Sergeant et al.5 who looked at family medicine residents in Ontario; Aldir et al.’s6 survey of practicing and resident doctors in Northeastern Ohio, USA, about their views of promotion; Barnes and Holcenberg’s7 survey of medical and pharmacy students at the University of Washington in 1970; Blake and Early’s8 survey of Missouri patients about their attitudes to gifts given by pharmaceutical companies to doctors; Madhaven et al.9, who surveyed West Virginia doctors about their attitude to gifts from the industry; and Keim’s10 survey of directors of emergency medicine programmes, and residents in these programmes, about their attitude to interactions with the pharmaceutical industry. Others include: Mainous et al.11, who surveyed 649 adults in Kentucky about their attitudes to doctors accepting gifts from the pharmaceutical industry; Reeder et al.12, who surveyed all chiefs of US emergency medicine residency programmes; Strang et al.13 who surveyed Canadian doctors; Lichstein et al.14 who surveyed directors of internal medicine residency programmes; and Dunn et al.15 who surveyed Ontario physicians.
CONCLUSION: These studies do not suggest any clear patterns in attitudes to promotion. Further research would be required to determine if variations in the findings depend on the population surveyed, and on the way questions were asked, who asked the questions, and in what context.