Intended for healthcare professionals

Education And Debate

Who pays for the pizza? Redefining the relationships between doctors and drug companies. 2: Disentanglement

BMJ 2003; 326 doi: (Published 29 May 2003) Cite this as: BMJ 2003;326:1193
  1. Ray Moynihan, journalist (
  1. 1 1312 21st Street NW, Washington, DC 20036, USA
  • Accepted 2 May 2003

If the American Medical Student Association has anything to do with it, relations between doctors and the pharmaceutical industry will soon look considerably different. Representing 30 000 students, interns, and residents throughout the United States, the association is running a campaign—PharmFree—calling for an end to gift giving, free lunches, sponsored education, and paid speaking.1

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Students are being urged to sign a PharmFree pledge to seek out unbiased sources of healthcare information and to take a recently revised Hippocratic oath, called a “model oath for the new physician,” which includes the commitments: “I will make medical decisions… free from the influence of advertising or promotion. I will not accept money, gifts, or hospitality that will create a conflict of interest in my education, practice, teaching, or research.”

The strange becomes familiar

The American Medical Student Association's campaign is inspired in part by the work of the New York based No Free Lunch, which boasts the motto “Just say no to drug reps,” hosts a pen amnesty,2 and, together with an Australian group called Healthy Skepticism, is urging doctors to turn away from industry backed education and information, towards independent materials.3 According to No Free Lunch, “Our quarrel is not with the pharmaceutical industry but with pharmaceutical industry promotion. The time has come to eliminate its influence from our practices.” These small campaigns are indications of a fundamental redefinition of the relationships between doctors and drug companies, as professional associations, standard setting bodies, and individual institutions around the world begin to disentangle some of the unhealthy flows of money and influence (box).

Moves towards disentanglement

  • Restrictions or prohibitions on drug representatives visiting doctors

  • Restrictions or prohibitions on educational events funded by industry

  • Prohibitions on individuals or organisations with conflicts of interest running accredited continuing medical education

  • Moves towards independently funded continuing medical education and …

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