An article to be published in Wednesday's Journal of the American Medical Association calls for rigid guidelines that would prohibit drug companies from providing physicians with gifts of any kind, saying that long-standing financial ties between the medical profession and pharmaceutical industry erode research integrity and hurt patient care. "No matter what you are told by any physician or administrator, these gifts -- no matter how small -- influence doctors' behavior," said David Rothman, president of the Institute on Medicine as a Profession in New York. The think tank at the Columbia University College of Physicians and Surgeons helped fund the report by a group of about a dozen medical experts. The report urged academic medical centers to take the lead in abolishing gifts of any size, including meals and payment for travel or for participating in continuing medical-education programs, and to strictly regulate ties between doctors and drug companies. Other recommendations include: replacing direct drug samples with a system of vouchers for low-income patients and insulating continuing medical education from industry influence by requiring companies to contribute to a central academic office that would disperse funds to individual programs.
The Pharmaceutical Research and Manufacturers of America, a trade group, and the American Medical Association did not respond to the specific recommendations of the report. However, both said they had ethics codes meant to help ensure that interactions between drug companies and doctors worked to the advantage of patients. PhRMA's 3-year-old voluntary code warns drug company representatives that "entertainment, expensive meals and gifts that are for personal use by the physician are not appropriate." "Only practices that do not compromise independent judgments of health providers, such as modest working meals, gifts of minimal value that support the medical practice and distribution of free samples, are permitted," according to the code.