by Caitlin Kenney

The cozy relationship between doctors and prescription drug companies has long made people queasy. Remember all those free pens and mugs? Now with the health care reform debate in full swing, there are new questions about the financial ties between physicians and industry. Here's a bit from today's Washington Post:

You may not be able to trust your mortgage broker, your car salesman or your congressman, but you can trust your doctor.

Can't you?

Patients might well ask themselves this question when they learn that 94 percent of physicians have "a relationship" with the pharmaceutical, medical device or other related industries, according to a national survey of physicians published two years ago in the New England Journal of Medicine.

It is unclear how much those businesses spend on marketing overall, but Integrated Medical Systems, a research firm, estimates that pharmaceutical companies spend more than $20 billion annually marketing directly to doctors.

The group Pharmaceutical Research and Manufacturers of America says only 1.5 cents of every dollar spent on health care goes to drug company profits, but with outpatient prescription medicines making up 10 cents of every dollar spent on health care in the U.S., it's worth knowing exactly where that money is going. A new bill sponsored by Senators Chuck Grassley and Herb Kohl aims to do just that. The Physician Payment Sunshine Act would require drug manufacturers to report any payments of more than $100 made to a physician.

Bonus: Pharma funding for medical classes draws scrutiny