Background <p>Digitalization is reshaping healthcare delivery, including how physicians and the pharmaceutical industry interact. Rheumatology care is a particularly dynamic field, where digital technologies are increasingly integrated into both clinical care and pharmaceutical engagement. Despite growing digital collaboration, little is known about healthcare professionals’ perspectives on these developments.</p> Objective <p>This study explores how stakeholders in German rheumatology perceive and experience digital interactions with the pharmaceutical industry, with a focus on evolving roles, opportunities, and ethical challenges.</p> Methods <p>We conducted a qualitative focus group study involving 18 stakeholders, including rheumatologists, medical assistants, and digital health professionals. Discussions focused on communication practices, collaborative models, and the integration of digital technologies. Data were analyzed using structured qualitative content analysis.</p> Results <p>Participants reported a shift from in-person to digital communication with pharmaceutical representatives. While digital formats were seen as more accessible and efficient, they also led to a perceived loss of personal interaction and an increase in information overload. Digital health applications, continuing education, and clinical trials with digital endpoints were identified as key areas of collaboration. Concerns included data ownership, blurred role boundaries, and the influence of commercial interests. Participants emphasized the need for clear governance structures and patient-centered, interoperable digital solutions.</p> Conclusion <p>Digitalization is altering the nature of collaboration between physicians and the pharmaceutical industry in rheumatology care. While offering new opportunities for engagement and innovation, these shifts raise ethical, structural, and practical challenges. Ensuring transparency, data protection, and role clarity will be essential to foster trust and optimize digital cooperation.</p>