PhRMA's Self-Imposed Limits on Gifts to Physicians Won't Solve Problem, Med Students Say

4/22/2002

From: Tim Clarke, Jr. of AMSA, 703-620-6600, ext. 207 or 301-814-2678 (cell); e-mail: prel@www.amsa.org

RESTON, Va., April 22 -- A recent decision by the Pharmaceutical Research and Manufacturers of America (PhRMA) to limit gifts to physicians may curb some abuses, but will not get to the heart of the problem, says the American Medical Student Association (AMSA).

PhRMA's new code prohibits gifts larger than $100 to physicians in the interest of promoting new therapies. Results of recent studies have shown, however, that even accepting small promotional items can have an effect on prescribing patterns, not necessarily in the interest of patient care.

"A voluntary resolution on the part of industry is a positive gesture, but it is not stringent enough, and with no mechanism of enforcement, it is unlikely to make significant change," says Jaya Agrawal, AMSA president and a fourth-year medical student at Brown Medical School. "The industry claims its promotional strategies serve as information dissemination, but studies show that 'information' from the industry can be inaccurate and misleading," Agrawal continues.

The problem, however, lies not only with the drug industry, but also with the medical profession. "Accepting gifts that can influence patient care is a clear conflict of interest; practicing ethical medicine requires a physician to seek out objective sources of information, rather than making decisions based on advertising and promotion," says Agrawal. "Unfortunately, neither medical schools nor professional societies have demonstrated effective leadership on this issue."

During their annual convention last month, medical students passed new policy in the AMSA House of Delegates, prohibiting pharmaceutical advertising in any Association forum. Furthermore, the new policy encourages medical students not to accept any promotional gifts, large or small from the industry. Student leaders then updated the to emphasize avoiding gifts and financial arrangements that produce conflicts of interest in patient care. "Medical students are concerned because their calling is at stake. Students worry that practices such as accepting gifts meant to influence medical decision-making are detrimental to medicine as a profession and contribute to an erosion of public trust in physicians," says Agrawal.

AMSA's Revitalizing Professionalism Campaign, launched this week, encourages students to update the Oath used at graduation ceremonies, improve the teaching of professionalism in medical schools, address school policies regarding student interaction with pharmaceutical representatives, and take a pledge to remain "pharmfree." AMSA (http://www.amsa.org/) is the nation's oldest and largest independent medical student association of more than 30,000 physicians-in-training.