" Q. Surely you're not suggesting that something as inconsequential as a pen
could possibly influence what I prescribe?

A. That's exactly what we're suggesting. And the social science literature
suggests the same. Gifts create relationships; they create obligation, the
need to reciprocate (See Katz, et al). For this reason even small gifts can
be disproportionately influential. Though many individuals, as well as most
professional society guidelines make distinctions among gifts of small and
large value (permitting the former while proscribing the latter), presuming
that larger gifts influence more than smaller gifts, this distinction is
probably baseless (see Dana & Lowenstein)."

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