Drug company gifts - corruption of medical judgment and education?

[Edit note April 21, 2007 - spelling in the title and "labels"]
I don't know about the rest of you, but while it's possible that I can be bought, it's not for the price of a free pen or a lunch. I pay $100 extra for my subscription to Contraception because I won't sign off on the mission statement for the Association for Reproductive Health Professionals, for pity's sake.

I guess that since doctors are such an unreliable and untrustworthy lot(who can somehow trusted with sharp objects and every personal detail about your life and body), we shouldn't permit them to accept give-ways from salesmen.

Come on! Doctors need education in ethics and practice making ethical choices. But, this is not the way to teach them: assuming that their patient's life is worth less than an ink pen bearing advertising.

However, I do hate seeing the drug samples lumped into the "free gifts" prohibition. Even the well-to-do are helped when we can give them a a day's worth of antibiotics to get them going or a week's worth of BP meds to see how they handle the new med. The poor and the working poor who live from payday to payday or have to get by on a limited formulary and limited number of scripts a month depend on my samples, at least until we can get them on the indigent program for the drug.

The "bioethicists" at the blog.bioethics.net, run by the editors of the American Journal of Bioethics, claim to have proved that we are influenced by pens, back in 2003. (In a Journal that maintains closed access to articles even 3 years after publication, and which is difficult to subscribe to, because subscriptions appear to run according to the calendar year.) The social science Ph.D.'s often seem hostile toward physicians, and this is one of the subjects that brings it out in them.

From the Kaisernetwork.org:

Tuesday, September 12, 2006

Prescription Drugs

Stanford University Medical Center Expected To Announce Policy Banning Doctors From Receiving Drug Industry Gifts

Stanford University Medical Center on Tuesday is expected to announce a policy under which physicians will no longer be allowed to accept gifts from pharmaceutical sales representatives in an effort to limit the drug industry's influence on doctors' medical choices, the New York Times reports. The policy, set to take effect Oct. 1, would prohibit doctors from accepting even small gifts such as pens or mugs from sales representatives for pharmaceutical, medical device and other companies. The policy also will prohibit doctors from accepting free drug samples and from publishing articles in medical journals that are underwritten by drug companies. Doctors who purchase medical equipment will be responsible for reporting any financial relationship they have with medical device suppliers, and, in some cases, could be excluded from the purchasing process. The new policy will not affect consulting agreements between physicians and companies that develop drugs or devices, which already are covered by an existing conflict-of-interest policy. The Times reports that the "move is part of a reaction against corporate influence on medicine at a time of growing concern over the safety and rising cost of drug and medical devices." The pharmaceutical industry spends about 90% of its $21 billion marketing budget on physicians each year, according to an article published in the Journal of the American Medical Association in January that encouraged academic medical centers to adopt no-gift policies. The article stated even small gifts can engender a sense of obligation, while free drug samples are "a powerful inducement for physicians and patients to rely on medications that are expensive but not more effective."

Comments
Stanford School of Medicine Dean Philip Pizzo said, "We want to secure the public trust to value what happens in academic medicine," adding that the policy would cost the institution millions of dollars per year. "Many faculty members and departments have become dependent on sponsored meals from industry in order to run seminars," Pizzo said. David Mangus, director of the Stanford Center for Biomedical Ethics and a contributor to the new policy, said it would lead to "a pretty major change in our culture." Scott Lassman, senior assistant general counsel for the Pharmaceutical Research and Manufacturers of America, said the new policy is a "disservice to patients and physicians," adding, "The company sales representatives, in our point of view, have a lot of useful information on drug products and how to use them, and how not to use them" (Pollack, New York Times, 9/12).