September 12, 2006

Stanford: No More Small Gifts

New York Times reports on the dramatic embrace by Stanford of the principles at the heart of the AMA report recommending against acceptance of even small gifts from pharmaceutical companies. AJOB's own David Magnus helped his institution create the policy, which has teeth:
''Gift giving creates a reciprocal obligation that is a powerful force, and pharmaceutical companies know this very well,'' said David Magnus, director of the Stanford Center for Biomedical Ethics who helped write the new policy. ''So we're discouraging it from happening anywhere at the medical center.''
No free samples. No ghost authorship of articles. No coffee mugs, drug reps dropping in without appointments, not even any pens. It's all over for pharma trinkets, folks. The old line, nicely delivered in the AP piece, just doesn't fly anymore:
...if I was concerned that my doctor was influenced by a pen or a slice of pizza, I would find another doctor.
Pens do influence physicians. The key study proving that small gifts have a big effect was published in The American Journal of Bioethics in 2003, and though you may be thinking "but obviously small gifts work, or drug companies wouldn't spend tens of millions on them, or more, every year," the data confirming that fact somehow remained a matter of advertising research, and then of bioethics conversation, until the JAMA report - and even then nothing really changed until a few schools picked up the mantle.

But Stanford, which is per capita (with its tiny but hyperproductive faculty) easily the most engaged in relationships that transfer research into technology, well, when Stanford locks out the drug companies it is a sea change.

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