Those long lines at the food trucks around Penn may be about to get longer: The Hospital of the University of Pennsylvania (HUP) has banned its staff from accepting gifts of any size—including free lunches—from pharmaceutical representatives who visit during office hours.
“Our view is that gifts create a sense of reciprocity,” says Dr. Patrick J. Brennan, the chief medical officer of Penn’s Health System who is helping to remodel its relationship with drug-makers. “While I don’t think anybody is thinking about who paid for the last pizza when they’re writing prescriptions, the relationship and gifting creates a positive feeling about an organization that can be translated into prescribing habits.”
Research confirms that there is persuasive power in the smallest of freebies—even those logo-laden pens and notepads—and in January, the Journal of the American Medical Association urged doctors to turn down all gifts.
Brennan says HUP actually began to reexamine its gift policies three years ago; after many conversations and a symposium were held on the issue, the hospital determined it needed to adjust its relationship with the pharmaceutical industry. “It’s a relationship that’s challenging but mutually beneficial in important ways,” he notes. “We don’t want to damage it, but we want to ensure it’s conducted in a proper way.”
Under the new rules, industry reps can still make appointments to meet with individual doctors or groups at HUP. They “will have to bring value, not food, to the meetings, and the relationship will stand on its own merits,” Brennan says.
Though HUP can’t police what its doctors do after hours, it will discourage them from attending social events or dining on drug-makers’ dimes even then.
“We’re not trying to demonize the industry,” says Brennan, adding that HUP wants to maintain scientific and educational ties with drug companies.
On one level, the new rules will actually give the companies more access than they’ve had before, he says. “We’re creating a Center for Evidence Based Practice that will help inform our formulary decision-making”—deciding what catalogue of drugs to have available for administering to patients. For the first time HUP will invite industry leaders to share information about their products as part of that decision-making process.
So far the public reaction to the announcement has been very positive, Brennan says. Though he is only aware of one other hospital that is banning gifts at this time (Yale-NewHaven), Brennan says, “I think we’re taking a leadership position and others will follow.”
—S.F.