From an unexpected source, a major medical revolution is in the making

Easy access denied

Doctors are constantly hounded by drug company salespeople. That’s a given.

What most people don’t realize is that drug reps begin hounding doctors long before they actually become doctors.

It’s despicable, but it’s nearly every med student’s introduction to the drug business. Sales reps show up bearing gifts of meals, textbooks, merchandise, and (of course) plenty of free drug samples.

According to a recent review, the majority of those med students have “significant exposure” to drug company promotion.

Last year, Australian researchers reviewed 14 surveys (mostly conducted in North America) that explored students’ attitudes about drug representative access to students, instructors, and administrators.

According to the results, students generally believe that note pads and pens with logos are fine. Gifts of textbooks, stethoscopes and a nice meal now and then are also just fine. But most of them draw the line there. They say that social outings, drug samples, vacations, and funding for travel to conferences are inappropriate.

However, that still leaves a fair number of students who said all those perks were completely appropriate.

Ah, what good little drug-friendly docs THEY’RE going to be!

A revolution brewing

A majority of students surveyed appear to be conflicted about the drug industry.

On one hand, most believe that drug rep presentations have educational value, even though they know the presentations are biased. And while most believe that interactions with industry reps won’t influence their prescribing behaviors (ah, youth!), they also feel underprepared for one-on-one interactions, so they want their schools to provide formal guidance in dealing with reps.

What they’re probably not expecting is guidance from their fellow students.

About 10 years ago, the American Medical Student Association began a PharmFree Campaign. The goal: To advocate for “evidence-based rather than marketing-based prescribing practices” and the removal of conflicts of interest.

Come on…that’s practically Un-American…

And despite that, the most unexpected part was the effectiveness of their campaign.

Several years ago, PharmFree began keeping a yearly scorecard to assign grades to med schools based on their policies for drug company interaction with students and faculty.

In 2009, 45 out of 152 schools received an A or B grade. Last month the newest scorecard was published with very encouraging news: 79 of 152 schools now rate an A or a B.

An AMSA announcement about the report adds: “Nearly one-third of medical schools now teach medical students to understand institutional conflict of interest policies, to recognize how industry promotion and marketing can influence clinical judgment and to consider the ethics around conflict of interest.”

Nice work, AMSA students. Now if only we could get through to your parents and professors…

Sources:
“What do Medical Students Think about Pharmaceutical Promotion?” Australian Medical Student Journal, Vol. 1, No. 1, April 2010, amsj.org
“Majority of U.S. Medical Schools Have Strong Pharmaceutical Conflict-of-Interest Policies; Medical Student Survey Finds” American Medical Student Association, Press Release, 12/15/10, amsa.org