Please add your voice to those of providers around the Commonwealth in calling for ethical industry interaction standards. In the next two weeks our broad coalition will deliver this letter to key officials at the MA Department of Public Health, Executive Office of Health and Human Services, Governor’s Office, and the Public Health Council members. We need your signature to show that we, as providers from the Commonwealth and across the country, are disappointed in these weakened regulations and expect higher ethical standards in our profession.
To the Department of Public Health:
As physicians, resident physicians, medical students, and allied health professionals in the Commonwealth and
across the country, we write to express strong concern over the Department of
Public Health’s emergency regulations on the Pharmaceutical and Medical Device
Gift Ban and Disclosure Law (105 CMR 970.000). We urge DPH to amend the current
emergency regulations to protect the well-being of our patients and to uphold
ethical standards of our profession.
The DPH’s emergency
regulations fail to create clear limits on how much pharmaceutical and medical
device companies can spend on food and refreshments while promoting treatments
to prescribers. The unfortunate fact is that every dollar spent on marketing
makes health care more expensive for Massachusetts residents. One in five
Americans already skimp on groceries just to fill their prescriptions. We call
on you to create a clear definition of “modest” in your regulations to ensure
that no Bay Stater has to choose between medications and putting dinner on the
The current regulations
also contradict ethical norms of the medical profession, which acknowledge that
gifts and meals skew prescribing decisions towards more expensive
treatments—even when there is no evidence that they provide a medical benefit.
The most preeminent institutions of our profession, including the Institute of
Medicine and the Association of American Medical Colleges, have called for an
outright ban on industry gifts and meals. In Massachusetts, every single
medical school prohibits faculty from receiving industry-funded meals on
campus. Perhaps most tellingly, PhRMA itself bans industry-funded meals for
physicians in restaurants within its voluntary code of ethics, citing fear that
education will not be the primary focus of a restaurant meal.
We therefore call for
the following changes to DPH regulations on allowable meals and refreshments:
“modest” with a clear monetary limit.
The emergency regulations
define “modest” meals as “what a health care practitioner might purchase
when dining at his or her own expense.” While we believe that no
industry funding of meals should be permitted, within the current
legislative context, the DPH definition of “modest” is inappropriately
vague and unenforceable. We call for the DPH to institute a clear monetary
limit on allowable meals, such as those that exist for state and federal
employees on work-related meals.
alcohol at industry-funded events and presentations.
Providing doctors alcohol is inappropriate
when medical information is being exchanged. Scientific studies support
the common sense intuition that alcohol impairs the capacities to learn
and to make effective decisions, an unacceptable risk when information
presented can impact the health of many patients.
adequate information on how money is spent on newly allowable meals.
The DPH must understand the
impact of newly allowable meals on our profession and our patients. DPH
regulations should include provisions that collect and make public information
on the location of presentations, a description of products promoted, and
estimates of total and per-capita expenditures at each event, as required
by statute. Much of this information is not required by federal law in the
Physician Payment Sunshine Act, and is important information for our patients
The true “emergency”
that we must confront is that seven in ten Americans believe that their
doctors’ decisions are “too influenced” by pharmaceutical companies. Lack of
trust erodes the impact a provider can have on the health of our patients.
Please act to protect the trust at the heart of our relationships with our
patients. We urge you to amend the current DPH regulations to include all of
the above changes.
This organizing effort is spearheaded by members of the American Medical Student Association and the National Physicians Alliance.
Please contact us
with any comments, questions, or concerns!