Medical school extends ban on industry gifts, free samples to adjunct faculty

Philip Pizzo

Philip Pizzo

The 660 community physicians who serve as adjunct clinical faculty at the Stanford University School of Medicine now must abide by the medical center’s policy on industry interactions, according to new guidelines that took effect March 15.

The adjunct clinical faculty — community physicians who volunteer time teaching at the school — will now come under the medical center’s sweeping industry-interactions policy, enacted in 2006. That means as a condition for using a Stanford title, these individuals must follow the same policies as full-time faculty and thus are prohibited from accepting industry gifts of any size, including drug samples, under any circumstance. They also will not be allowed to participate in speakers’ bureaus, in which they are paid by companies to deliver company-prepared and/or company-provided presentations on drugs, devices or other commercial products. Adjunct faculty who do not follow the regulations will no longer be able to carry a Stanford title.

“Our local, national and global communities do not differentiate whether an ‘adjunct’ title refers to a paid or unpaid member of our school community,” said Philip Pizzo, MD, dean of the medical school. “If an adjunct clinical faculty member does not follow our policy on industry interactions, that creates confusion in the eyes of the public, and our reputation can be tarnished. Thus, anyone with a Stanford title must adhere to the same industry-interaction policies that apply to our full-time faculty as a precondition for maintaining that title.”

Stanford was among the first academic medical centers to implement a broad-based industry-interaction policy, which aims to limit the potential influence of pharmaceutical and biomedical companies in the day-to-day clinical and educational activities of the medical center. Since the policy was enacted in 2006, there have been a number of revisions to it, most notably a 2008 ban on direct commercial support of continuing medical education at the school.

In addition to forbidding faculty members from accepting gifts and free samples and participating in speakers’ bureaus, the policy bans industry representatives from patient-care areas and prohibits faculty from publishing articles ghostwritten by industry representatives, along with other provisions.

When the policy was first developed, medical center officials debated whether it should apply to the adjunct faculty, said David Stevenson, MD, senior associate dean for academic affairs and vice dean of the medical school. It was decided then to exempt adjunct faculty members from the policy except when they were actively involved in teaching at Stanford or using their Stanford titles.

“It did not seem appropriate then to intrude in their private affairs, in that they all have private practices,” said Stevenson, a professor of pediatrics. “But we came to realize that they always have the Stanford identity attached to them, even when they are not working on our behalf. Even if they make their best effort not to advertise themselves inappropriately, people unavoidably use those Stanford titles. So we reasoned that if the title were important to them, they should be asked to comply with the same policies to which all other faculty comply.”

The adjunct faculty now will have to certify in writing that they are in compliance with the policy as part of their annual review process, he said. Adjunct faculty members who have existing commitments to industry will be allowed a transition time to sever those relationships, if they want to maintain their Stanford title, Stevenson said.

The revised policy also extends the ban on free drug samples to pharmacies at the medical center. Previously, it was permitted for companies to provide free samples to pharmacies at the medical center’s two hospitals. The pharmacies, in turn, would distribute these to needy patients. Both hospitals have since discontinued this practice. The revised policy makes it clear that the medical school, as well as the two hospitals and their respective clinics, will no longer accept any industry drug samples.

To view the policy, go to: http://med.stanford.edu/coi/siip/policy.html.


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