A national movement to reduce conflicts-of-interest at medical schools and academic medical centers

Go PharmFree. PharmFree because the practice of pharmaceutical gifting to students and physicians increases the costs of health care for patients and does not primarily serve patient interests. PharmFree because medical students want to be honest with future patients about why a particular medication was prescribed without compromising personal and professional integrity. PharmFree because medical students want to treat future patients using modalities supported by the best existing clinical evidence, not carefully packaged advertising. Patients rightly expect and deserve this from the medical community.

- from AMSA's 2002 PharmFree launch statement

AMSA's PharmFree Campaign is a national movement to reduce conflicts-of-interest at medical schools and academic medical centers. Throughout its history, AMSA's leaders and members have taken pride in fostering honesty and integrity, and promoting the interests of our patients and communities. Affordable and quality health care for all is an issue that tugged on the heartstrings of AMSA's founders in the 1950s, and it continues as AMSA's rallying cry today.

In 2002, AMSA launched the nationwide PharmFree Campaign as an educational effort targeted at medical students in order to continue teaching the qualities of honesty, humility and accountability in undergraduate medical education and beyond. Without these qualities, both the credibility of the medical community-and the public trust given to it-will erode. While AMSA recognizes that pharmaceutical companies provide a valuable resource for research and development of new and potentially lifesaving medications, we also realize that the industry has sales representatives deliver sales pitches to doctors. We encourage all physicians-in-training and health-care providers to seek out evidence-based and unbiased sources of information rather than to rely on pharmaceutical industry representatives for "education."

AMSA banned pharmaceutical advertising and sponsorships at regional and national conferences, in AMSA's magazine, The New Physician, on the organization's Web site (www.amsa.org) and as a source of corporate donations. AMSA remains one of the few national organizations to completely eschew all pharmaceutical advertisements and sponsorships, including sites like (https://adrafinil.com).

The initial PharmFree effort was based on educational tools, like PowerPoint presentations and projects-in-a-box designed both by AMSA and No Free Lunch (www.nofreelunch.org). These tools were meant to inform medical students and empower them to educate their fellow medical students and other health-care professionals, and to make well-formed decisions regarding evidence-based medicine and PharmFree. These educational efforts were supplemented by a bi-weekly newsletter on pharma issues, an ethics primer for AMSA members and a presentation designed specifically for first-year medical students about pharma issues, sleeping pills uk and how to change medical school curricula.

In 2003, the AMSA Board of Trustees adopted "Transforming the Culture of Medical Education" as one of the organization's four national strategic priorities. The PharmFree Campaign, with its call to revitalize professionalism, remains a central component of that priority. The next year, AMSA's Annual Convention centered on "Revitalizing Professionalism: Physicians Worthy of the Public Trust" and introduced AMSA members to PharmFree issues through keynote speakers, special programming and awareness-building information sessions.

The first National PharmFree Day was held on December 8, 2004. AMSA members held a "pen drop" and dumped thousands of pharma-branded pens and paraphernalia outside of the Pfizer headquarters. The next year, National PharmFree Day included chapter-based activities, such as lectures, debates, drug pen collections and policy discussions with clerkship directors and school administrators. "PharmFree Liberated" stickers showed up on medical school campuses across the country. National PharmFree Day has become a premier AMSA event.

The next step in the PharmFree Campaign was 2005's Counterdetailing Initiative. This effort took the PharmFree campaign to the next level by drawing on the knowledge base already established and introducing a focus on local projects and grassroots activism. Counterdetailing focused not only on physicians-in-training, but also on current healthcare professionals and encouraged the practice of evidence-based, rather than industry-influenced, medicine.

In 2006, with the backing of AMSA's 68,000 members, AMSA leaders undertook a national survey of medical school pharma policies. The result is AMSA's 2007 PharmFree Scorecard, which ranks U.S. medical schools based on their policies to limit the access and influence of pharmaceutical companies and their representatives at schools and academic teaching centers.

The PharmFree movement will revitalize professionalism in medical education and healthcare provision. All medical students should learn about the ethics of drug company interaction with health professionals and make the rational, informed decision to eschew "free" gifts from the pharmaceutical industry throughout their training careers. Every practicing physician should practice evidence-based medicine using modalities supported by the best existing clinical evidence-not carefully packaged advertising-and continue to uphold personal and professional integrity.