Medical colleges must ban gifts, says report

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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.”

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