Industry shouldn't be allowed, expected to regulate itself

THE PHARMACEUTICAL Research and Manufacturers of America recently updated its restrictions, and as the next generation of physicians, the American Medical Student Association is pleased that the trade association is finally acknowledging that gifts do not belong in the healthcare system. Though it is an improvement over previous policy, these voluntary restrictions are clearly inadequate. The new code leaves many holes, such as allowances for "occasional meals" and the absence of a clear enforcement structure for these voluntary guidelines. Without consequences, these updates don't translate to better patient care.

Given that pharmaceutical companies have a fiduciary responsibility to their shareholders, and given that they are a business that must take profits into consideration, the pharmaceutical industry cannot be expected to self-regulate. Most importantly, this code preserves the industry's practice of aggressively marketing their drugs to physicians through pharmaceutical sales representatives. The industry's marketing to doctors has been estimated at $28 billion to $46 billion per year, with additional promotion by the medical device industry. This equates, conservatively, to $35,000 per year in marketing directed at each physician, on average.

DR. BRIAN HURLEY, Reston, Va.
The writer is president of the American Medical Student Association