Should medical students be advised to have no contact with drug companies due to the risks of poor patient care and inappropriate prescribing?   This issue is debated in the latest edition of the Medical Journal of Australia.

Associate Professor Wendy Rogers, from the Department of Medical Education, Flinders University, and colleagues from the University of Adelaide and the Women's and Children's Hospital, say there are serious ethical issues and potential harms that should be considered by medical educators and students when making decisions about forming relationships with the pharmaceutical industry.

"The implication is that the gifts of books to students by pharmaceutical companies can be harmful and effective without students being aware of it," said A/Professor Rogers.

"Because medical students may be flattered by the attention, as well as pleased by gifts from representatives, a strategy of no contact may be the best way to avoid establishing relationships of this type.

"Given that any 'freebies' for students are in fact paid for by patients and healthcare services, this loss of integrity is acute."

A related article in this edition of MJA by Dr Kerry Breen, Chair of the National Health and Medical Research Council's Australian Health Ethics Committee, draws attention to the overwhelming evidence that prescribing habits of Australia's doctors are open to industry influence.

"My criticism is of the naїveté of doctors and/or their unwillingness to accept overwhelming evidence that the techniques used by the industry to increase prescribing of their products actually work," Dr Breen said.

Some of the available evidence about doctors' prescribing habits identifies that between
80 per cent and 95 per cent of doctors see industry representatives regularly.  Other studies demonstrate that attendance at conferences sponsored by the industry produces altered prescribing patterns for at least the next six months.

Common interactions between the pharmaceutical industry and doctors identified by
Dr Breen include a wide range of marketing techniques and sponsorship of medical conferences and medical products (such as computer software).  In addition, the industry fosters the use of  "opinion leaders" from within the medical profession to indirectly promote their products.

President of the Australian Medical Students' Association, Mr Matthew Hutchinson, says medical students appear to occupy a loophole in an otherwise highly regulated environment.

"For this reason, AMSA is taking proactive steps to formulate policy and produce its own code of conduct for medical students," Mr Hutchinson said.

"AMSA feels strongly that our responsibility is, at the very least, to educate medical students about the pros and cons.   In this way, medical students can make better-informed decisions about how far they take their relationships with the pharmaceutical industry."

The Medical Journal of Australia is a publication of the Australian Medical Association.

CONTACT:     Associate Professor Wendy Rogers, 08 8204 3132 / 0422 538 592; 
                   wendy.rogers@flinders.edu.au

                   Dr Kerry Breen.  Dr Breen is not contactable until 24 April.  03 9419 0110 (B/H); 
                   kerrybreen@access.net.au

                   Mr Matthew Hutchinson, 08 8410 4180; 0404 293 936 (B/H)
                   matthew.hutchinson@student.adelaide.edu.au; president@amsa.org.au

                   Judith Tokley, AMA Public Affairs 0408 824 306