- The Washington Times - Tuesday, January 24, 2006

Medical professors are pressuring medical schools and college hospitals to establish stricter rules that would ban doctors from accepting any gifts, drug samples or direct grants from drug companies or medical device makers.

The group, which released its report in today’s issue of the Journal of American Medical Association, argued that gifts and grants sent directly to medical departments or doctors have too much influence on patient diagnoses.

“If there is one thing our committee agreed upon, it is that there is no such thing as a free gift,” said David Rothman, a lead author of the report and social medicine professor at Columbia University.

Mr. Rothman said the group analyzed a series of medical studies in the past few years, which showed corporate gifts as having an effect on a doctor’s decision-making.

The report comes a day after a whistleblower lawsuit was filed against Minneapolis medical device company Medtronic Inc. The lawsuit said the company improperly paid millions in dollars to more than a dozen doctors nationwide, which prompted them to perform unnecessary spinal surgeries and affected their judgment.

Medtronic, which would not comment on the lawsuit, said it has a strict code of conduct for any contracts with doctors.

The report focused on academic medical centers in the hope of changing policies at institutions where doctors facing the issue treat patients. The centers also set the ethical tone for medical students, said Jordan Cohen, a co-author and outgoing president of the Association of American Medical Colleges, a Washington medical group.

The policy report was funded by the Institute of Medicine as a Profession, a New York medical foundation that was originally funded by billionaire George Soros, and the American Board of Internal Medicine Foundation, the nonprofit arm of the Philadelphia board, which sets the U.S. standards for doctors practicing internal medicine.

Among the recommendations, the report calls for a ban on all gifts, even those with less than $100 in value. Gifts include promotional items, free meals and payments for travel or time to a health event.

Additionally, the report urged medical hospitals to stop accepting free drug samples and instead set up a system with drug companies to receive drug vouchers for low-income patients.

Medical centers also were encouraged to lump research or continuing-education grants for doctors into a common fund, which would be distributed by an administrative team.

The group’s proposed rules are stricter than those of the American Medical Association.

The Chicago group’s guidelines allow doctors to accept gifts “that entail a benefit to patients and are of modest value, and no gift should be accepted if there are strings attached.”

Johns Hopkins University’s School of Medicine in Baltimore allows doctors to take free samples from drug representatives for “evaluation purposes.” The samples cannot be given to patients, said Julie Gottlieb, the school’s assistant dean for policy coordination.

Employees and medical staff also can receive gifts worth an undetermined “nominal” value, but they, with medical students, must attend ethics training courses, she said.

Medical students at the University of Maryland’s School of Medicine in Baltimore must complete an ethics class that addresses corporate gifts, said John Talbott, project director for the school’s professionalism project.

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