Rationalizing Bribes

You wouldn’t accept a bribe…. Or would you?

A new Carnegie Mellon study uncovers how some doctors rationalize the acceptance of gifts from pharmaceutical companies.

It’s not blatant bribery. In fact, most physicians rationalize the acceptance of gifts subconsciously.

According to Sunita Sah, the study’s lead author (and physician herself) who is completing her Ph.D. at the Tepper School, “This finding suggests that even justifications that people don’t accept at a conscious level can nonetheless help them to rationalize behavior that they otherwise might find unacceptable.”

The study divided physicians into three groups.
  1. Group one was first asked about the sacrifices they had to make in order to get their medical education, followed by a series of questions regarding the acceptability of receiving gifts from pharmaceutical companies.
  2. Group two was also asked about their sacrifices, and then asked to consider whether such sacrifices and hardships could justify taking gifts.
  3. Group three – the control group – was simply asked about the acceptability of receiving gifts without questions related to the sacrifices they made while getting their medical education.
How did it turn out?

Reminding physicians of their medical training and the hardships they endured more than doubled their willingness to accept gifts from 21.7 percent to 47.5 percent. Furthermore, prompting them with a possible rationalization for accepting gifts increased their willingness to 60.3 percent.

The results were surprising, because when asked if their educational burdens justified accepting gifts, most physicians said it did not.

Bottom line:

“Given how easy it is for doctors to rationalize accepting gifts, which from other research, we know influences their prescribing behavior, the inescapable conclusion is that gifts should simply be prohibited,” explained George Loewenstein, the Herbert A. Simon Professor of Economics and Psychology, and co-author of the study.

This study was funded by CMU’s internal departmental research funds and was published in the Journal of American Medical Association.

Read additional coverage in the Pittsburgh Post Gazette and the Pittsburgh Business Times.

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