On Oct. 11, 2008, the Wisconsin Medical Society (WMS)--an association of more than 11,000 medical doctors in the state of Wisconsin--implemented a full ban on gifts to physicians. Specifically, the WMS policy prohibits physicians from accepting gifts from any provider of products that they prescribe to their patients. This includes personal items, office supplies, food, travel and time costs, or payment for participation in online continuing medical education (CME).
According to WMS, the goal is to restore patient trust in physicians' unbiased decision-making by eliminating any actual or potential conflicts between a physician' s medical judgment and a physician's interest in continuing to receive gifts from manufacturers and wholesalers. According to WMS President Steven Bergin, MD, the new policy establishes the principle that "individual physicians should take a bright line approach to accepting items from companies that make products or drugs that the physician might end of prescribing or recommending to his or her patients." He further states that "physicians have the responsibility to make sure nothing gets in the way of [the physician-patient] relationship--or even appears to get in the way."
In addition to the gift ban, the new Wisconsin policy includes the following items:
- The direct provision of drug samples to patients should be limited. (The policy also suggests that samples should be replaced by vouchers.)
- Physicians serving on formulary committees must disclose any commercial relationship with a "health product company," and recuse themselves from the formulary process.
- CME providers cannot accept support directly from health product companies. Rather, the policy suggests that CME providers should create a medical education fund to accept unrestricted donations that would be dispersed according to the CME provider's policies. CME contributions would be required to be disclosed as public information by the CME provider on the Internet.
- Physicians are prohibited from serving on speaker bureaus for health product companies, and from "ghostwriting" (e.g., the practice whereby physicians permit their names to be listed as authors for articles actually written by manufacturers).
- Consulting arrangements must be subject to contracts that require physicians to provide specific "deliverables" in exchange for compensation.
These new rules can be found in WMS Policy ETH-004, "The Relationship of the Profession to the Health Product Industry."