The companies are getting more and more sophisticated about their marketing techniques. Now, they can go to the Medical Associations and buy biographical data on individual doctors including their prescription license numbers. Then they can buy information from pharmacies about what a particular physician is prescribing and keep track of what tends to influence him or her. Doctors publicly deny that they are influenced in their prescribing habits. But it is now an open secret that they are indirectly influenced by important scientific information .

It is quite unfortunate that these companies get around dishonest doctors to offer lucrative gifts for influencing them. They may change society's perception of the medical professionals as serving the best interest of patients. Also, accepting a gift establishes a relationship between the physician and the drug company that obliges a response from the physician. Accepting gifts and the resulting relationship have ethical implications as well. First, the use of patients' money to pay for gifts can be unjust. Second, the fiduciary relationship between physician and patient may be threatened if prescribing practices are affected.

Physicians need to avoid being naïve. It is highly expected of them that they need to quit protesting that because they’re scientists, and marketing should not  influence them. They need to understand that the pen and the golfing trip are not designed to buy their souls; these "perks" are designed to foster familiarity and comfort with the drugs and sometimes create a gift relationship and the gratitude that goes along with it. That makes them very effective marketing tools. 

Consumers also have to be more realistic. So many people feel entitled to the latest, greatest, hottest medications and treatments, but most of us are financially insulated by our insurance from the cost of this care. Very few care what is actually happening in the name of medical treatment.

Rewarding physicians with gifts and attention for their allegiance to their product and company despite what may be ethically appropriate is now a regular event. Writing generic names is not accepted by the doctors. Doctors are on their trip abroad evey now and then at the offer of the companies. They flaunt their status by telling about their foreign trips. In exchange, they slavishly follow the instructions of the medical companies. Drug companies will now have to disclose to income tax officials on demand the names of doctors who have accepted gifts from them in a fresh government move to curb unethical promotional practices that may hurt patients’ health and pockets.

Drug companies spend money like anything for  promoting their drugs to physicians.Drug Reps use unbelievable tactics to manipulate doctors to be generous with free samples to leverage sales. It is interesting to know that  the companies commonly hire former cheerleaders, ex-models, former athletes and military members to ensure their reps to have a certain appealing look and outgoing personality. “Pharmaceutical companies spend billions of dollars annually to ensure that physicians most susceptible to marketing prescribe the most expensive, most promoted drugs to the most people possible.

They provide samples, gifts, services, and flattery to a subset of physicians. Cheerful and charming, bearing food and gifts, drug reps provide respite and sympathy; they appreciate how hard doctor's lives are, and seem only to want to ease their burdens. But every word, every courtesy, every gift, and every piece of information provided is carefully crafted, not to assist doctors or patients, but to increase market share for targeted drugs.

It is the jobs of the drug reps  to figure out what a physician's price is. For some it's dinner at the finest restaurants, for others  it is foreign trip , either single or with the spouse, but at the most basic level, everything is for sale and everything is an exchange. It is not desirable to deny  that physicians are susceptible to corporate influence because they are overworked, overwhelmed with information and paperwork, and feel underappreciated.

But corruption percolates from the higher to the lower. Unsuspecting medical students, senior doctors who are on the verge of their retirements  and residential medical officers of the nursing homes  are among the drug companies’ best targets.They favour the drug paradigm set by the companies  in exchange of monetary gains. Some avaricious doctors work as paid slaves  of the companies. They get easily brainwashed by the medical representatives. It is heartening  to note that the Income tax department has at last come forward  to restrain the  greedy doctors who accept gifts. Now onwards , they  need to declare their equivalent value as taxable income. The income tax department has said drug companies cannot claim money spent on gifts to doctors.

But who pays heed to the directives of the  Medical Council of India, the country’s highest medical regulator which had three years ago issued guidelines prohibiting doctors from accepting gifts from pharmaceutical companies above the value of Rs 1,000. Acceptance of gifts is a violation of the MCI’s code of professional conduct. The laws have a good many gaps and without the knowledge of who’s giving and who’s taking, it’s really very difficult for the Medical Council to punish such unethical doctors who for pleasing their wives and daughters bunk the legal restraints. It is matter of deep concern that  the continued, persistent violation” of the code of ethics of the MCI by doctors occurs in the big hospitals of the mega cities, some of which are having the ‘Centre of Excellence’ title.