Survey: Family Medicine Residencies Increasingly Pharm-Free

According to a survey stimulated by the PharmedOut project at Georgetown and AMSA's PharmFree initiative (subscription required to access), family medicine residencies in the US are gradually decreasing their involvement with the pharmaceutical industry.

The survey studied family medicine residencies in 2008 and was hampered by only a 62% response rate. The authors concluded that more than two-thirds of (responding) programs limit industry access to residents in various ways, and one-quarter can be classified as pharm-free--contracting with only 10 percent of residencies that disallowed industry support in 1992. They noted similar trends in internal medicine, where others have noted a drop in industry support of residencies from 89% in 1990 to 56% in 2007. Many respondents noted that the policies in the institutions (medical centers or hospitals) where the residency was located had recently changed and this seems to have prompted changing residency policies as well.

Large academic medical centers have recently taken leadership in developing "pharm-free" policies, so the authors were interested to note that community-based residency programs seemed just as likely to move in a pharm-free direction as those located within academic centers.

One sticking point remains just how one educates residents regarding the pros and cons of dealing with drug marketers. Residencies were not rated as "pharm-free" if they allowed access of drug detailers to residents, even if within the context of offering formal education about how to deal with detailers. Faculty in many residencies insist that residents need this "real world" experience and that faculty present can counter any biased messages conveyed by the detailers. The authors reply that companies would not allow detailers to attend these sessions if they did not believe that a positive message about seeing detailers in the future would be conveyed to residents as a result. The entire discussion section is well worth reading as it addresses a number of similar issues.

Fugh-Berman A, Brown SR, Trippett R, et al. Closing the door on Pharma? A national survey of family medicine residencies regarding industry interactions. Academic Medicine 86:649-654, May 2011.