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A Policy Proposal for Academic Medical Centers

Troyen A. Brennan, MD, MPH; David J. Rothman, PhD; Linda Blank; David Blumenthal, MD, MPP; Susan C. Chimonas, PhD; Jordan J. Cohen, MD; Janlori Goldman, JD; Jerome P. Kassirer, MD; Harry Kimball, MD; James Naughton, MD; Neil Smelser, PhD

JAMA. 2006;295:429-433.

Conflicts of interest between physicians' commitment to patient care and the desire of pharmaceutical companies and their representatives to sell their products pose challenges to the principles of medical professionalism. These conflicts occur when physicians have motives or are in situations for which reasonable observers could conclude that the moral requirements of the physician's roles are or will be compromised. Although physician groups, the manufacturers, and the federal government have instituted self-regulation of marketing, research in the psychology and social science of gift receipt and giving indicates that current controls will not satisfactorily protect the interests of patients. More stringent regulation is necessary, including the elimination or modification of common practices related to small gifts, pharmaceutical samples, continuing medical education, funds for physician travel, speakers bureaus, ghostwriting, and consulting and research contracts. We propose a policy under which academic medical centers would take the lead in eliminating the conflicts of interest that still characterize the relationship between physicians and the health care industry.

Author Affiliations: Harvard Medical School, Boston, Mass (Drs Brennan and Blumenthal); Institute on Medicine as a Profession/Columbia University College of Physicians and Surgeons, New York, NY (Drs Rothman, Chimonas, and Goldman); Association of American Medical Colleges, Washington, DC (Dr Cohen and Ms Blank); Tufts University School of Medicine, Boston, Mass (Dr Kassirer); University of Washington School of Medicine, Seattle (Dr Kimball); Alliance Medical Group and University of California San Francisco School of Medicine, San Francisco (Dr Naughton); and University of California, Berkeley (Dr Smelser).

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