Understanding Physician–Pharmaceutical Industry Interactions is a long-overdue book summarizing deliberations that have spanned many years. I am a PGY (postgraduate year) 51; Dr. Shaili Jain is a PGY 8. Although two generations apart, we are in complete agreement with the need for coalesced thinking about the conflicts of self-interest in the relationship between the pharmaceutical industry and the profession of medicine. Dr. Jain is to be complimented for undertaking this subject that has undoubtedly caused her consternation as a young physician.

This topic is very important for all health professionals who prescribe medicines or medical devices. Health care now consumes $2 trillion annually and is approaching 17% of the gross national product. And, as the costs continue to escalate, individuals, families, industry, and businesses and municipal, county, state and federal governments falter economically. Prescribing medical professionals, who are responsible for at least 75% of the annual cost of health care, unfortunately are often unaware of the cost of the drugs, tests, services and supplies they prescribe. The patients, except for their co-payments, are uninterested because of the confusion and complexities of billing, and, after all, a third party is responsible for payment. To curtail the rising cost of health care, everyone must become cost conscious. No other service or product is purchased so blindly.

Business ethics are different from medical ethics. In the business climate it is common for industry to reward and entice their vendors in order to stimulate sales.