About 84 percent of doctors in a nationwide survey reported having some type of relationship with the pharmaceutical and medical device industry in 2009, according to a study published in the latest Archives of Internal Medicine. That’s down from five years ago, when the study found that 9 in 10 doctors were accepting free drug samples, gifts, or direct payments from industry.

NPR, which partnered with us on our recent Dollars for Docs investigation, spelled out some of the perks covered by the study:

Free samples of drugs: About 63 percent of the surveyed doctors accepted those last year compared with 78 percent in 2009.

Gifts (meals and drinks mostly): Some 71 percent of docs took those in the recent survey compared with 83 percent five years earlier.

Direct payments (mainly for speaking and consulting): About 14 percent of docs say they got paid for something they did for industry in 2009. That's half the proportion who said that in 2004.

Our recent investigation focused on the last category—direct payments to doctors for speaking and consulting for drug companies. The Los Angeles Times, looking at the same survey, breaks this category down even further:

Fewer doctors report speaking on behalf of drug companies (8.6 percent in 2009 versus 16 percent in 2004), consulting for pharmaceutical firms (6.7 percent versus 18 percent) and participating in drug company advisory boards (4.6 percent versus 9 percent).

According to our Dollars for Docs database, about 17,700 providers have accepted such payments since 2009 from seven major pharmaceutical companies. (We'll be keeping this database updated as more information becomes available, though keep in mind our numbers don’t include payments from medical device companies.)

Last week we also reported that since 2009, 43 doctors earned more than $200,000 in compensation for their work with these companies. As we’ve noted, whether such payments present a true conflict of interest—or simply the appearance of it—is still a subject of much debate in the field of medicine.

Studies in recent years have also called into question whether free drug samples are truly in the best interest of patients, or whether they make doctors “more likely to prescribe more expensive, brand-name drugs” when cheaper and equally effective alternatives are available.

PhRMA, a drug industry trade group, has disputed this, arguing that “physicians prescribe medicines based on a wide range of factors, not simply receipt of free prescription drug samples.”

In 2008, the trade group released new guidelines prohibiting pharmaceutical companies from wining and dining healthcare providers and from giving out swag. (The companies are still allowed to provide meals to doctors in conjunction with informational presentations.) PhRMA told Reuters that the rules were intended to avoid the appearance of “an unprofessional relationship.”

The group, in comments to the Times, said that many of the doctor-industry relationships tracked by the most recent survey were “perfectly appropriate and in the interest of patients."

Inform our investigations: Do you have information or expertise relevant to this story? Help us and journalists around the country by sharing your stories and experiences.

Follow @mariancw