Medical schools and teaching hospitals should ban gifts to
physicians and other faculty, staff, students and trainees, whether on-site or
off-site, including food and travel, said the Association of American Medical
Colleges (AAMC).
According to a report of the AAMC Task Force on Industry
Funding of Medical Education, sales reps should see docs only by invitation or
appointment, and medical schools should develop a means for reps to detail “by
invitation in faculty supervised structured group settings that provide the
opportunity for interaction and critical evaluation.” Student interaction with
reps “should occur only for educational purposes under faculty supervision.”
On CME, medical colleges “should develop audit mechanisms to
assure compliance” with ACCME standards and “should establish a central CME
office through which all requests for industry support and receipt of funds for
CME activity are coordinated and overseen.” Faculty should be “strongly
discouraged” from participating in pharma-funded speakers' bureaus. Students,
faculty and trainees should be banned from participating in non-ACCME
accredited industry events or accepting payment for attendance at
industry-sponsored meetings.
And schools should ban ghostwriting “on presentations of any
kind, oral or written …. by any party, industry or otherwise,” said AAMC.
The report, by an AAMC task force chaired by former Merck
head Roy Vagelos and studded with industry bigwigs, included a few key
dissents. Amgen's Kevin Sharer supported the “explicit recommendations of the
task force but said he's “not in a position to endorse the text” and added that
“it is understandable that industry and academe will not agree completely on
the final wording of any report given our differing roles in healthcare.”
Pfizer's Jeff Kindler and Lilly's Sidney Taurel supported all of the recommendations
of the report except for that of a ban on industry-sponsored speaker programs,
and added: “We do so without endorsing all of the supporting arguments used in
the body of the report,” and suggested that “the reasoning for many of the
recommendations is directionally correct, but more often than not the potential
issues addressed reflect perceptions rather than proven consequences.”
In its introduction to the Macy Foundation-funded report, the
task force wrote: “Over recent decades, medical schools and teaching hospitals
have become increasingly dependent on industry support of their core
educational missions. This reliance raises concerns because such support, including
gifts, can influence the objectivity and integrity of academic teaching,
learning and practice. The validity of these concerns is supported by a robust
body of psychosocial evidence and an emerging body of neurobiological evidence
regarding the effects of establishing interpersonal relationships and gifts on
recipients' choices and decisions.”