Israeli Experience Dealing with Physicians and Pharmaceutical Companies

The relationship between physicians and pharmaceutical companies is an integral part of the health system in the whole world. The mutual need in such a relationship requires us, as a society, to examine its influence on the individual and the system as a whole, to face the ethical problems that arise from this relationship and to consider setting limitations. In recent years, the tendency to limit this relationship has been increasing. In Israel, the physicians and the pharmaceuticals decided to set their own limitations by signing an ethical code entitled "The Israeli Ethical Convention between Physicians and the Pharmaceutical Industry". This convention set boundaries to the relationship and, in addition, set up a committee, headed by a judge emeritus, whose function is to enforce the ethical code. In the research we examined this relationship in Israel and especially this unique code and the point of view of policy makers towards it. We chose 45 policy-makers from various groups (government, HMO'S, physicians, pharmaceutical companies and the public) and used in depth interviews and qualitative research methods in order to examine their positions towards this relationship and the Code.

The findings were surprising, as 49% of the policy-makers, including those who signed the Code, do not believe that this is the right solution to the problems raised by the relationship. 14% were opposed it and 37% supported it. It would seem that the lack of trust in the Code on the part of all the parties proves that initial ground work was not done to make all the relevant bodies reach agreement on it. Moreover, we pointed out that the lack of trust of policy-makers in the Code and in the ability of the parties to set the boundaries and to lessen the influence of the pharmaceutical companies over physicians might lead us to a situation of loss of trust between patients and their physician, which is detrimental to the medical profession and to society at large.

A full commitment to the appropriate execution of this relationship, by all the parties, is the basis for building a system which will benefit and advance the health system and the medical field. This commitment will help us to build standards which uphold the public's trust in the physicians and the health system. A patient's trust in the physician, who is treating him, is the basis of the medical profession. We must safeguard this trust.