Plan Seeks to Slash Industry Influence on Doctors

CHICAGO – In a drastic proposal for limiting drug company influence on doctors and patient care, a group of prominent physicians says medical associations and their leaders should reject almost all industry funding.

That means big medical groups would need to find other ways to pay for things like doctors' continuing education classes, or gatherings where treatment guidelines are written. Guideline writers also should have no industry ties, the proposal recommends.

Some "sacrifice" likely would result — fewer events or higher membership dues, the proposal suggests.

"It has not always been flattering to see how physicians' relationships to industry appear to have colored their judgment in matters of public health," said Dr. Steven Nissen, a proposal co-author and former president of the American College of Cardiology.

Examples include disease treatment guidelines recommending certain drugs, written by doctors who own stock in those drugs' makers. Or, medical meetings where doctors tote around book bags, pens and identification badges emblazoned with drug company logos.

Some groups have eliminated those freebies, but the proposal — appearing in Wednesday's Journal of the American Medical Association — says they should work toward a complete ban on industry funding.

One exception is money paid for medical meeting exhibits, where drug and device makers display their wares. Doctors "can easily distinguish these marketing activities from educational presentations," the proposal says. Another such exception cited is advertising in medical journals that helps finance journal operations.

Industry funding of research by medical groups and their members should come with no strings attached and the organizations, not drug makers, should decide how to use it, the proposal says.

It joins the growing calls for more restrictions to prevent inappropriate drug company influence on patient care. Some medical schools, doctor and industry groups have already adopted limits or sought more disclosure.

The new proposal's 11 authors include Dr. Catherine DeAngelis, JAMA's editor-in-chief; Dr. James Scully, CEO of the American Psychiatric Association, and Dr. Gerald Thomson, former president of the American College of Physicians. It reflects their opinions, not those of their medical groups.

Dr. Jerome Kassirer, a longtime critic of doctor-industry ties, praised the proposal but said it's unlikely to be fully adopted by large medical groups, which depend on industry funding for many activities.

Dr. Joseph M. Heyman, chairman of the AMA's board, said in a written statement that the AMA has limits including restrictions on drug company gifts to physicians, but he did not indicate if the group would consider adopting harsher limits.