The America Medical Association, through its ruling House of Delegates, voiced its support for over-the-counter sales of morning-after birth control pills but punted on a resolution calling on physicians to refuse payment from pharmaceutical company representatives wanting to "shadow" physicians at work.
The AMA approved a resolution Monday during its annual meeting opposing the position of the Food and Drug Administration of the birth control pills, saying the agency is wrong to reject such sales and urging doctors to write advance prescriptions.
The resolution passed without debate and had drawn applause and wide support at a committee meeting the day before.
Taken within 72 hours of unprotected intercourse, the drug can cut a woman's chances of pregnancy by up to 89%. But it can be hard to find a doctor to write a prescription in time, especially on weekends and holidays.
"The overwhelming data is that it is safe, effective and usable across age groups," said Vivian Dickerson, M.D., president of the American College of Obstetricians and Gynecologists, in remarks to the committee. "Clearly we know accidents can happen to anyone."
FDA acting drug chief Steven Galson, M.D., overruled his own staff to issue the rejection last month. The FDA cited concern about young teenagers' use of emergency contraception without a doctor's guidance, but Galson said the agency will reconsider the decision if given more data.
The also rejected a proposal that would have softened the group's stance against pharmaceutical industry freebies, including paying for doctors' trips to industry-sponsored educational conferences.
The proposal was offered by Peter Lavine, M.D., a Washington, D.C., orthopedic surgeon who argued that doctors deserve to be compensated for attending such conferences, where they often learn crucial information about new medical equipment and procedures.
It doesn't make ethical sense to allow money for tuition but not hotels, he said Sunday during a committee hearing on his proposal. "The policy is a mess."
Lavine said many physicians ignore the existing policy, which says doctors should only accept gifts that have some direct benefit to patients and discourages things like free trips, hotel accommodations and other personal expenses for attending conferences.
But several other doctors said that physicians are bombarded with pressure from drug companies marketing their products and that the proposal would increase the chances for them to be unduly influenced.
The AMA's policy-making delegates, who meet again today, agreed without debate to accept a committee's recommendation rejecting the proposal.
On a related topic, the delegates deferred action on a proposal aimed at strengthening the AMA's policy discouraging "shadowing," the practice of drug company representatives sitting in on patients' visits with doctors.
The proposal would have urged doctors to refuse payment--sometimes hundreds of dollars daily--for shadowing, which critics say is meant to influence what drugs are prescribed.
The proposal was referred for further review and a clarified version may be reintroduced at the AMA's December meeting.
