August 30, 2001

AMA Warns Docs on Ethics of Drug Company Gifts

CHICAGO (Reuters Health) - The American Medical Association (AMA) 
is 
spending about $650,000--with about $600,000 of the money coming 
from the 
pharmaceutical industry--to remind doctors that it is unethical to 
take 
gifts valued at more than $100 from drug companies.

In addition to the $50,000 paid by the AMA to fund the campaign, it 
also 
donated staff time totaling an in-kind contribution of $400,000.

Ever since 1990, the AMA's Code of Ethics has specifically stated it 
is 
unethical for physicians to accept expensive gifts, trips, lavish 
meals 
or special perks such as tickets to sporting events.

In an interview with Reuters Health, Dr. Randolph D. Smoak Jr., an 
Orangeburg, South Carolina surgeon and immediate past president of 
the 
AMA, said that many doctors who started practice in the last 10 
years are 
unaware of the ethical guidelines. According to the AMA, 182,213 
physicians have joined the physician workforce since the guidelines 
were 
first approved and circulated.

Smoak said the AMA decided on an 18-month educational campaign 
as a means 
of getting the word out.

The first part of the campaign is an informational mailing to 
medical 
organizations, medical schools and hospitals. AMA will follow up 
with 
more information on its Web site, including detailed examples of 
questionable situations.

For example, Smoak said, a physician attending a medical meeting 
might be 
asked by a pharmaceutical company rep to ``come along on a golf 
outing. 
Now the greens fees could be $25 or they could be more than $100. 
The 
doctor may say 'great' without thinking he or she is in danger of 
violating an ethicalprinciple.''

Smoak said the AMA doesn't want doctors to just say no to golf, but 
``the 
ethical answer is to say 'yes, but I'll just take care of the greens' 
fees myself.'''

Critics have charged the AMA with violating its own principles by 
using 
drug company money to finance the education campaign, but Smoak 
said that 
charge is groundless. An ethical breach occurs, he said, when a 
physician 
accepts a gift and that action then influences the way he or she 
treats a 
patient. For example, a physician might write more prescriptions for 
a 
drug after accepting an expensive gift from a person who is paid to 
promote that drug.

``Our use of funds from pharmaceutical companies to help in this 
educational effort does not affect patient care,'' Smoak said.

Jackie Cottrell, a spokeswoman for the Pharmaceutical Research and 
Manufacturers of America, a Washington, DC-based drug company 
trade 
group, said that drug company reps also need to be reminded about 
the 
ethical guidelines. She said the same information packet is being 
sent to 
executives and managers at 30 drug companies that belong to her 
group.