Materials you can use to educate others

You can help this educational initiative by raising awareness with your key audiences, helping us reach more physicians and industry representatives. If you communicate with your colleagues through a newsletter, journal or Web site, please publish the AMA guidelines, along with information about them. If you are involved in industry, please strive to educate your company and sales force about the initiative and its goals.

Included at this site are materials you may download for use in your internal publications. The booklet "What you should know about gifts to physicians from industry" is also included here for printing in PDF format. 

To order free copies of the booklet, please call (312) 464-5101.

Other materials include:

Newsletter article for physicians

OP/ED

Advertisement (PDF, 163KB)

Booklet (PDF, 113KB)

Newsletter article for physicians

What should you know about gifts to physicians from industry?
Find out—and earn CME credit—with free AMA online educational modules

Sensational stories about the influence of pharmaceutical companies on physicians and inappropriate gifts from industry continue to make the news. In 2001, the American Medical Association launched a major national initiative to encourage physicians, residents, medical students and industry representatives to adhere to ethical guidelines on promotional gifts from industry. This effort is a collaboration of the AMA and the Working Group for the Communication of Ethical Guidelines on Gifts to Physicians from Industry, which represents more than 30 medical and industry organizations.

Free educational resources available online
The AMA-led initiative is introducing a series of online educational modules. Now you can have 24-hour instant access to the AMA’s "What You Should Know About Gifts to Physicians from Industry," a four-part series of educational modules offered in two versions:

• An online self-study version for which the AMA has designated one PRA Category 1 CME credit; and
• Downloadable resource materials instructors can use to build one-hour learning experiences. Materials include a presenter’s guide, PowerPoint slides and a participant's handout. Local sites can issue CME credit for the classroom version of these downloadable educational modules.

Each module presents important concepts, illustrated with case examples. The educational modules will help satisfy ACGME requirements for education on professionalism and industry professional relationships. 

Modules are based on guidelines in the AMA Code of Medical Ethics
The material in the educational modules is based on the 1990 AMA Council on Ethical and Judicial Affairs (CEJA) Opinion 8.061, "Gifts to Physicians from Industry," which is part of the AMA Code of Medical Ethics. There are no new policies or guidelines in the modules.

The modules also refer to guidelines enacted by the Pharmaceutical Research and Manufacturers of America (PhRMA)—as well as those developed by other medical, industry and government groups—as appropriate to give a broad-based understanding of the issues involved in the ethics of gift giving. The PhRMA code and others are very similar in spirit and substance to the AMA guidelines.

The modules offer an in-depth perspective on the interaction between physicians and members of the pharmaceutical and medical device industries, provide useful guidance on decision-making, and discuss how physicians’ ethical behavior affects the quality of the patient-physician relationship.

To view the modules online.

A deeper look at the issues surrounding gifts to physicians from industry
By Alan R. Nelson, MD

As a busy physician, how would you respond to the following situations?

1. While evaluating a new type of scanner for a clinic, one of the manufacturers of the scanner being considered offers to fly you, the physician doing the assessment, to a training center in a distant resort area for two days with all expenses paid.
   
   Are there possible conflicts in this offer?
   
   

2. You and some of your fellow physicians are invited to a one-day consultants’ forum sponsored by a pharmaceutical company at a luxury hotel. Your opinions will be solicited on issues surrounding the management and care of patients with disease X and on a product’s marketing plan and positions. The afternoon is free with tickets provided to a baseball game and a gourmet buffet with open bar. Air transportation and hotel accommodations are covered, and each participant will receive a $500 honorarium.
   
   Will the physicians in this case be acting as true consultants? Why or why not?

If you are like most physicians, you have probably faced situations like these involving industry representatives who are marketing their products. The answers to these ethical questions don’t always come easily. (The answers to the questions above, by the way, are listed at the end of this article.)

The American Medical Association recognizes the challenging ethical questions facing today’s physicians—and they’re doing something to help. The AMA, in collaboration with the Working Group for the Communication of Ethical Guidelines on Gifts to Physicians from Industry—a group representing more than 30 medical and industry organizations—is introducing a series of four free online educational modules on gifts to physicians from industry.

Each one-hour module is offered in two versions: an online self-study version for which the AMA has designated one Category 1 CME credit; and downloadable resource materials including a presenter's guide, PowerPoint slides and a participant's handout. Instructors can use these resource materials to build one-hour learning sessions.

As physicians, we have unique responsibilities requiring us to act according to high standards of conduct. Physicians must protect the best interests of patients with clinical decisions free of undue influence, and ensure that our interactions with industry are free of any conflicts of interest that could compromise or appear to compromise our judgment.

Not all financial arrangements with industry are inappropriate. But how do you know when an arrangement is ethical and when it is not? The AMA educational modules offer an in-depth analysis of key issues facing you as a physician. The modules are based on the AMA's 1990 Council on Ethical and Judicial Affairs (CEJA) Opinion 8.061, "Gifts to Physicians from Industry,"which is part of the AMA Code of Medical Ethics.

The AMA's guidelines are straightforward and are widely accepted as an appropriate standard to guide our interactions with representatives of pharmaceutical, device and medical equipment companies. In brief, the guidelines state that gifts to physicians from industry are acceptable if they benefit patients, are of modest value, and have no strings attached.

The educational modules are available free online at the AMA initiative's Web site.

Ongoing interaction and communication between physicians and industry is vital for good patient care, but we must ensure that those interactions are always ethically based.

Now, as promised, here are the answers to the two questions posed earlier:

1. To ensure there are no actual or perceived conflicts of interest if a particular offer is accepted, you could accept training only after a supplier has been chosen; clarify that the training schedule and agenda are appropriate for your objectives; and arrange transportation, lodging and meals at your own expense. 

2. The exchange of professional services is vague and there appear to be no specific criteria determining the selection of consultants. There is no clear objective to the session. The honorarium can be assumed to be fair market value and set in advance. However, the absence of a contract, and the appropriateness of the baseball venue along with the gourmet buffet and open bar, all shed doubt on the legitimacy of the activity.

If you missed an answer, don't worry it's not uncommon. But now may be a good time to visit the AMA initiative's Web site to become familiar with gift-giving guidelines so you will be ready next time a question comes up.

Alan R. Nelson, MD, is a former AMA president and chair of the AMA’s Working Group for the Communication of Ethical Guidelines on Gifts to Physicians from Industry.

To order free copies of the pocket card, "What you should know about gifts to physicians from industry," call (312) 464-5101.