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January 1, 1992

Of Mugs and Marketing: The Robin Hood Solution

Author Affiliations

University of North Carolina at Chapel Hill

JAMA. 1992;267(1):55. doi:10.1001/jama.1992.03480010063019

To the Editor.  —I've recently moved from a rural private practice to academia, and Dr Goldstein's Commentary1 on the largess of pharmaceutical companies has helped me to understand better a phenomenon I've found perplexing. While in practice, my partner and I refused to let drug company representatives in the door. We saw the ethical downside as being too great, and although we knew that we couldn't truly purify ourselves, we felt compelled to attempt integrity. We were sorely tempted by the appeal of free samples for our many poor patients but realized that accepting them would put us at the top of a slippery slope. Therefore, we prescribed inexpensive antibiotics and older, generic medications for chronic illnesses whenever possible. There were times, I must admit, when quality care demanded our prescribing an expensive new medicine—when we regretted not having a full sample closet—but we got by.My new job,