A re­port in the Sept. 20 Jour­­nal of the American Medical Ass­ociation drew lukewarm consumer media attention last month, given its findings. It as­serted that an­nual spending on medical research in the Unit­ed States, at nearly $100 billion, has doubled in just the past de­cade.

What may be surprising, given the attention that has been paid in re­cent years to the influence of phar­ma­ceutical manufacturers on re­search, is that the proportion of government versus in­dustry funding for research has re­mained fairly constant over the past decade (57 percent, industry; 28 percent, NIH).

My first thought when I see reports such as this one is always, how does that relate to ophthalmology? Too often that can't be answered: too small a piece of the pie to warrant specific study.

That's why we're indebted to Dr. Bill Stewart and his colleagues at Pharmaceutical Research Network. This month (page 51), they report the results of a survey in which they collected ophthalmologists' impressions and assessment of the pharmaceutical in­dustry.

To most of us, figures like $100 billion and terms like Big Phar­ma are ab­stractions, too big to have any mean­ing in our lives. To most ophthalmologists, pharma is the field rep who walks in the door.

One of the interesting questions in the survey addressed the relationship between those reps and their customers in ophthalmology.

Asked to name the three most important benefits that field reps provide, the respondents cited the provision of: free samples of medicines for patients (named by 90 percent); in­­vitations to educational events (50 percent); and useful medical in­for­mation (42 percent).

Quite a bit farther down the list, at just 12 percent, was invitations to social events. Farther still, at 6 percent, was the quality of the personal relationship.

It won't receive much consumer media attention either, but Dr. Stew­art's study appears to have found at least one area of medicine in which substance trumps perks or personal relationships.