The new Pharmaceutical Research and Manufacturers of America (PhRMA) Code
on Interactions with Health Care Providers, as described in a July press
release, highlights the new restriction on drug reps' providing
restaurant meals without a speaker who is a health care professional
(interestingly, a practice that doesn't even occur in my area), but there
is no restriction on restaurant meals at programs that provide speakers who
are health care professionals.
Why does PhRMA make this distinction? PhRMA is trying to appear as if it
cares about what it would call "the appearance of conflict of
interest" without actually doing anything about real conflict of
I feel that we in psychiatry, and especially APA, should lead the way in
this area—not just follow the guidelines put out by PhRMA.
I would like APA to recommend that psychiatrists go a step further. To
avoid a conflict of interest, or even the appearance of a conflict of
interest, psychiatrists would agree to not accept free food at either drug-rep
presentations or speaker programs. So, no free promotional items, no free
food. This policy, of course, does not prohibit attendance at these programs,
but it may ensure a more sober assessment of their content.
Just one other point. Could someone explain to me why free food and alcohol
are provided at speaker programs? Can doctors not afford their own food? Is
this the only way that drug companies can get doctors to show up? What does
this say about the quality of the programs? What does this say about doctors?
Perhaps the questionable practice of doctors being paid by drug companies to
talk to doctors will end if nobody shows up willing to pay the bill.