Healthy Skepticism Library item: 1062

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Hirsch M.
UCSF med students say no to drug reps
The San Francisco Bay Guardian 2005-2005 Apr-May 27-3
http://www.sfbg.com/39/30/news_ucsf.html

Full text:

Doctors attending the American College of Physicians conference, billed as “internal medicine’s premier educational event” and held at the Moscone Center April 14 through 16, were greeted with an array of goodies handed out by representatives of Big Pharma.

Purdue Pharma, the maker of Oxycontin, served up warm chocolate chip cookies. Pfizer had a “laser emblazer” station so visitors to its booth could personalize their free pens. Novartis was blending old-fashioned milkshakes, presumably to wash down the chocolate chip cookies.

What’s wrong with a few edible treats and tchotchkes, the sort of stuff that’s handed out at all trade shows?

Nothing – except that it jacks up health care costs and clouds physicians’ clinical judgment, says Bob Goodman, an internist in New York City.

That, and the fact that while Big Pharma was free to make its pitch in the Moscone exhibition hall, Goodman was denied a chance to set up a booth of his own.

Goodman is the founder of No Free Lunch, a coalition of physicians, pharmacists, nurses, and dentists who want doctors to kick the habit of taking freebies from the pharmaceutical industry. Wearing a green T- shirt that said, “Just say no to drug reps,” Goodman stalked the halls of the ACP conference April 15 with a group of dissident UCSF med students, handing out copies of the ACP guidelines, which strongly discourage accepting gifts.

“The acceptance of even small gifts can affect clinical judgment and heighten the perception (as well as the reality) of a conflict of interest.” That’s not Goodman I’m quoting. It’s the ACP.

“If we think it’s wrong to do this, and most of the accredited institutions think it is, then we have to be consistent,” Goodman told me as we walked through the Moscone Center.

(In the interest of disclosure, I should note that I discussed this story with my partner, who is secretary-vice president of the American Medical Students Association chapter at UCSF, the group that was protesting with Goodman.)

Goodman said things were much worse 15 years ago, before the drug industry set its own guidelines on gift giving and companies were handing out trips to Hawaii. But he realized how corrupt the system still is when he was told he couldn’t have an exhibition table alongside the drug companies.

According to the Wall Street Journal, which first reported on Goodman’s run-in with ACP gatekeepers, the organization’s Ethics and Human Rights Committee chair said Goodman’s request was denied because “there’s a difference between exhibiting and activism.” Evidently, marketing stuff is OK; saying something isn’t.

When I contacted ACP, David Sgrignoli, the senior vice president for marketing and communications, agreed that the organization could ban all the gifts from its annual gathering. But instead, it dances around the ethical issues and lets the doctors decide for themselves.

Sgrignoli told me ACP reviews every item that’s handed out at the exhibit to make sure of two things. “One, that it is of minimal value and that it will not have an impact on the objective clinical judgment of our physicians. And two, that it has some utilization in a medical setting.”

“If in any circumstance a physician feels that the gifts that we approve are going to cloud their clinical judgment, they should refuse acceptance of those. But in most cases we really do not believe that certain of those approved giveaways will impact their clinical judgment,” he said.

Given the ongoing commodification of medicine, some AMSA members at UCSF figure docs need to display a little leadership. “It falls on the medical professional to say first and foremost, ‘Our job is to care for our patients as best we can,’” Kristin Rising, a third-year UCSF med student told me.