It has been a long time coming: the AAMC has finally taken a strong stance against the distribution of free gifts (from pens and bags to food, travel expenses, vacations, ghost-written papers, etc.) to physicians, medical school staff members, and students by pharmaceutical and medical device companies (reference). The AAMC is not a ruling body for medical schools, but it does provide guidelines and directives that most medical schools choose to follow. Responding to the growing efforts of companies to influence the medical decisions of doctors, the AAMC has proposed an all-out ban, no strings attached.
Surprisingly, several executives from major pharmaceutical companies including Amgen, Eli Lilly, and Pfizer were on the task force, although it seems their dissenting opinions were overruled by the majority. One of the Amgen representatives expressed conditional support for the AAMC’s report “because we have a different view about the accuracy concerning representations about the motives of the participants.” This is not entirely untrue, but it illustrates the subversive nature of the tactics many companies have used to influence prescription writing, device usage, and product endorsement behavior of physicians. Various studies have consistently demonstrated that physicians who accept gifts underestimate their susceptibility to influence by the drug and device makers over their medical practice decisions. Most physicians do not perceive their acceptance of free gifts as prostituting themselves to these companies, when in reality, they are allowing these companies to take advantage of their sense of entitlement (something often developed in medical school).
Some members of my generation of physicians-in-training might complain: “Our predecessors received free gifts and tens of thousands of dollars in speaking fees; why shouldn’t we?” My response: suck it up. How hard is it to buy your own pens and lunch? The movement within the field to expose financial conflicts of interest has done a reasonable job of revealing the extent of potential influence of drug and device makers over medical practice, but it is now our job to take a stand and say “no.”