Stanford University will bar physicians working at its two hospitals from accepting even the tiniest gifts from drug industry sales representatives to try to eliminate corporate influence from medical decisions, the school announced Tuesday.
The policy takes effect Oct. 1 and also bans accepting gifts from other companies such as medical device makers that do business with the hospitals. The policy also prohibits the doctors from accepting free drug samples and publishing articles in science journals that were ghost written by corporate authors. The industry's sales force also would be prohibited from areas where patients are seen and from dropping in without appointments, a common sales tactic.
Even coffee mugs, pens and other trinkets doled out by drug companies can't be accepted anymore.
Yale University and the University of Pennsylvania have announced similar policies and several other institutions are considering gift bans as they grapple with conflict of interest concerns and rising health care costs.
"In recent years we have witnessed an erosion of the public trust in the profession of medicine and even in the value of science," said Dr. Philip Pizzo, Stanford's medical school dean. "Part of that is related to the market forces that have increasingly converted medicine from a profession to a business, but a significant factor has also been the perception that physicians and scientists may be accepting gifts and gratuities from industry at the very time that the cost of drugs is skyrocketing."
In January, an article in the Journal of the American Medical Association said current relations with pharmaceutical representatives created conflicts of interest and urged academic medical centers to take the lead in adopting reforms. The article said the drug industry spends about $19 billion annually marketing to doctors.
"Gift giving creates a reciprocal obligation that is a powerful force, and pharmaceutical companies know this very well," said David Magnus, director of the Stanford Center for Biomedical Ethics who helped write the new policy. "So we're discouraging it from happening anywhere at the medical center."
The industry's trade group, the politically influential Pharmaceutical Research and Manufacturers of America, blasted Stanford's new policy as draconian and argued that cutting down on doctors and sales representatives meetings would actually hamper health care.
"The sales representatives are typically very well trained and have quite a bit of information," said Scott Lassman, a lawyer for the trade group. "They are cutting doctors off from very useful information that they can use to help treat their patients."
Lassman said the trade group instituted its own gift policy in 2002 that prohibits lavish gift giving.
"Lavish, expensive meals, tickets to ball games and golf outings are really inappropriate," Lassman said. "But if I was concerned that my doctor was influenced by a pen or a slice of pizza, I would find another doctor."