The Physicians-Drug Representative (PDR) relationship is a concerning ethical issue in the medical field. Negative effects resulting from these interactions affect major aspects of health institutions, such as knowledge of physicians and their prescribing practices. A better understanding of PDR interactions could be a key factor in minimizing the negative outcomes. The aim of this review was to discuss the PDR relationship from an ethical point of view and to give a better picture of what the current literature says. We performed a literate search in the databases (PubMed, Science Direct, MEDLINE, and Google Scholar) using the terms "Physicians-Drug Representative Relationship" "Medical Ethics" "Gift Acceptance" "Change in Knowledge" "Prescribing Behavior" "Interest Conflicts" "Physician-Patient Relations" "Pharmaceutical Marketing" to identify relevant articles. Subheadings were chosen and discussed in this review based on common measurements of previous related articles. The review showed that the interactions between the physicians and the pharmaceutical companies have multiple effects on physicians from different aspects, ranging from minimal changes in knowledge
into irrational changes in practice. Apparently, there is a need for more focus on the training programs of physicians regarding PDR interactions. Further studies should also focus on PDR implications on patients' perceptions and their general health status.
Key words: Physicians-drug representative relationship, medical ethics, gift acceptance, change in knowledge, prescribing behavior, conflict of interest, health care system, doctor-patient trust, pharmaceutical marketing