What does AMA say about gifts to doctors?

There is a rising concern about certain gifts given to medical practitioners. Some reflecting customary practices might not be fair and acceptable from the point of view of Medical Ethics Principles. It will be interesting to know about the guidelines stipulated by the American Medical Association to avoid such inappropriate gifts:

A note on the AMA website elaborates, “Many gifts given to physicians by companies in the pharmaceutical, device, and medical equipment industries serve an important and socially beneficial function. For example, companies have long provided funds for educational seminars and conferences. However, there has been growing concern about certain gifts from industry to physicians. Some gifts that reflect customary practices of industry may not be consistent with the Principles of Medical Ethics.

To avoid the acceptance of inappropriate gifts, physicians should observe the following guidelines:

  • No gifts should be accepted if there are strings attached. For example, physicians should not accept gifts if given in relation to their prescribing practices, it states. In addition, when companies underwrite medical conferences or lectures other than their own, responsibility for and control over the selection of content, faculty, educational methods, and materials should belong to the organizers of the conferences or lectures.
  • Individual gifts of minimal value are permissible as long as the gifts are related to the physician’s work (for e.g., pens and notepads). Any gifts accepted by physicians individually should primarily entail a benefit to patients and should not be of substantial value. Accordingly, textbooks, modest meals, and other gifts are appropriate if they serve a genuine educational function. Cash payments should not be accepted.
  • The use of drug samples for personal or family use is permissible as long as these practices do not interfere with patient access to drug samples. It would not be acceptable for non-retired physicians to request free pharmaceuticals for personal use or use by family members.
  • The Council on Ethical and Judicial Affairs defines a legitimate “conference” or “meeting” as any activity primarily dedicated to promoting objective scientific and educational activities and discourse and to furthering their knowledge on the topics being presented. However, an appropriate disclosure of financial support or conflict of interest should be made.
  • Subsidies to underwrite the costs of continuing medical education conferences or professional meetings can contribute to the improvement of patient care and therefore are permissible. Subsidies from industry should not be accepted directly or indirectly to pay for the costs of travel, lodging, or other personal expenses of physicians attending conferences or meetings. Scholarship or other special funds to permit medical students, residents, and fellows to attend carefully selected educational conferences may be permissible.
  • The guidelines apply to all forms of gifts, whether they are offered in person, through intermediaries, or through the Internet. Similarly, limitations on subsidies for educational activities should apply regardless of the setting in which, or the medium through which, the educational activity is offered.
  • Regarding companies sending their top prescribers, purchasers, or referrers on cruises, the AMA stipulates that there can be no link between prescribing or referring patterns and gifts. In addition, travel expenses, including cruises, are not permissible.

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