Background: Physicians should follow ethical principles in their relationships with industry and be mindful that such relationships-if they are perceived as conflicts of interest-can undermine trust in the patient-physician relationship.; Methods: By identifying potential pitfalls and safeguards that can help prevent problems, this article focuses on ensuring that physician-industry relationships do not result in ethical transgressions or cause damage to doctor-patient relationships.; Results: Patient trust in physicians can be undermined by the perception that a physician-investigator is operating in the best interest of the research rather than the best interest of the patient. Payments from the pharmaceutical industry to physician-investigators are transparent because of the Sunshine Act, and patients can easily determine if their personal physicians have received money from industry. Research subsidies from industry should represent fair market value for the work performed. Postmarketing trials with the primary goal of increasing familiarity with a drug and prescribing rates should be avoided. Medical societies play an important role in establishing standards for professional conduct.; Conclusion: Ethically sound actions in physician relationships with industry should be guided by professional standards, medical society guidelines, and local institutional policies.