ACP-ASIM Updates Ethical Advice for Relationships Between Physicians and Industry
(PHILADELPHIA, March 5, 2002) The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) has released guidelines for ethical business relationships between physicians, medical education providers, medical professional societies and for-profit entities. The article appears in the March 5, 2002, issue of Annals of Internal Medicine.
The two-part paper, which updates a 1990 American College of Physicians paper on physician-pharmaceutical industry relations, contains four guiding positions derived from the medical profession's basic responsibility to advocate for the patient's best interests. The first part of the paper offers advice to individual physicians about accepting gifts and entering into other financial relationships with industry. The second part of the paper provides guidance for medical education providers and professional medical societies that accept corporate funding.
William J. Hall, MD, president of ACP-ASIM, said, "We revisited the 1990 paper because of the growing influence of for-profit companies in medical practice, research and education and new kinds of business and financial relationships between physicians and industry. Physicians must take care that financial and other material relationships with industry don't threaten their independent judgment about patient care."
ACP-ASIM urges individual physicians, medical education organizations and other medical professional societies that accept pharmaceutical industry support for educational activities to avoid all industry relationships that might diminish their objectivity as they act in their patients' best interests.
ACP-ASIM "strongly discourages" physicians from accepting gifts, hospitality, trips and all types of subsidies from industry. However, rather than prohibiting acceptance of any gifts, the organization encourages physicians to make decisions on a case-by-case basis.
ACP-ASIM advises physicians to determine the purpose of the industry offer and ask what patients and colleagues would think if they knew of the offer or relationship. ACP-ASIM says that it might be acceptable for physicians to accept inexpensive gifts for office use, such as pens and calendars; low-cost gifts of an educational or patient-care nature, such a medical books; and modest hospitality, such as food at a legitimate educational program.
- ACP-ASIM advises physicians involved in financial relationships with industry (such as by giving talks, conducting research, referring patients for clinical trials, or investing in services or facilities) to avoid relationships that might compromise their objective clinical judgment or their ability to serve the best interest of patients. Physicians must disclose a financial interest in medical facilities or research studies to which they refer or recruit patients.
- Public and private providers of graduate and continuing medical education that accept industry support should be aware of potential conflicts of interest and should maintain complete control of program planning, content and delivery.
Medical professional societies that accept industry support or other external funding should be aware of the potential for conflicts of interest to develop. They should develop explicit policies to preserve the ethical standards and credibility of the society and the professionalism of their members.
"There are no easy answers to many ethical questions," said William E. Golden, MD, chair of the ACP-ASIM Ethics and Human Rights Committee that developed the paper. But the committee felt a duty to address these issues, and our decision was to promote the independent judgment and professionalism of our members."
The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) is the nation's largest medical specialty organization and the second-largest physician group. Its membership comprises more than 115,000 internal medicine physicians and medical students. Internists are specialists in the prevention, detection and treatment of illnesses that primarily affect adults.
Note to Editors: Beginning March 5, ACP-ASIM's Physician-Industry Relations paper will be available online at www.annals.org.
To interview William J. Hall, MD, ACP-ASIM president, or William E. Golden, MD, chair of the ACP-ASIM Ethics and Human Rights Committee, call Susan Anderson at 1-800-523-1546, ext. 2653 or 1-215-351-2653.