Backstory: A pill they won't swallow
Dutifully wearing collared shirts, ties, and the short white coats meant to keep all medical students humble, Chen Kenyon and Dustin Petersen don't look like rebels. They look scrubbed and eager to learn from any doctor in a long white coat.Skip to next paragraph
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But in the pockets of their shorter garments lurk symbols of a movement aiming to topple one of medicine's most entrenched traditions. Their pens read "PharmFree," which means they don't take personal gifts of any size from the pharmaceutical industry. And that is touching off a quiet ethics war reverberating through the halls of academia and hospitals across the country.
Messrs. Kenyon and Petersen are among a growing band of stethoscope-wearing students who believe the medical profession needs more detachment from big pharmaceutical firms.
Consequently, they're turning down everything from free catered meals to notepads, provoking debates among fellow students and quizzical looks from doctors.
"People will often ask, 'why didn't you take the pen? Or, why didn't you eat the lunch?'," says Kenyon, a Boston University medical student who packs a sandwich, apple, and granola bar almost every day so he won't have to eat meals sponsored by drugmakers.
"It gives you the green light to talk about it when somebody asks," adds Petersen, who swears his home-cooked pot roast and clam chowder leftovers taste better than the catered meals he refuses each week.
Behind the modest rebellion is the belief that taking gifts from drug companies creates a conflict of interest for doctors. The argument: To accept handouts is to feel indebted, and doctors indebted to drug firms may not be prescribing medicines based solely on what's best for their patients. The 60,000-member American Medical Student Association (AMSA) urges students and doctors alike to just say "no" to all personal gifts from drugmakers.
Doctors on the whole seem far less worried about the practice. The American Medical Association condones gift-taking from pharmaceutical representatives as long as no single gift is worth much more than $100. And drug companies seem to be finding plenty of takers: spending on marketing to physicians jumped from $12.1 billion in 1999 to $22 billion in 2003 ($16 billion of which was in free samples), according to data from Pharmaceutical Research and Manufacturers of America (PhRMA).
Against this backdrop, students are still convinced their cause is worth fighting, even if it means giving up a hot meal every day. "I don't think patients can trust us anymore," says Kristin Rising, a medical student at the University of California, San Francisco. "By accepting gifts, we're taking in biases that are going to affect patient care."
Others feel the same way. For the first time this year, between 500 and 1,000 students at 150 medical schools are canvassing 40,000 physicians nationwide. Their aim is to steer them to independent sources of information about drugs.
This "counter-detailing initiative" takes AMSA's three-year-old PharmFree project out of medical schools and into the trenches of the profession, where students hope to pique the consciences of future colleagues.
Other phases of the movement have been more brazen. Last year, for instance, a brigade of students marched on Pfizer offices in New York and dumped thousands of logo- emblazoned pens, given to the students by the company as gifts and intended as advertisements in their hands, back on the firm's doorstep.