White Coat Notes posted yesterday about a Massachusetts bill backed by physicians and medical students that would ban gifts to physicians and medical students that serve no other need than to influence prescribing practices. I’m firmly in support of this and, to be honest, have never understood the practice. The letter by Drs. Angell, Colemann, Kassirer, and Tosi to Governor Patrick and Senate President Murry and Speaker DiMasi say it all.

The question I have with gifting is this: what purpose does it serve in helping us do our job? I don’t have an issue with big companies and pharmaceutical companies helping to sponsor our educational events and conferences. I don’t have an issue with grants. Where I have the issue, and many others, is gifting that has no purpose other than to influence prescribing practices. We need unbiased information these days and help in keeping tabs of all the new drugs. What we do with the information after that needs to be unbiased for us to care as best we can for our patients.

This doesn’t mean that we are saying “gifts are bad”. Some gifts are wonderful. I’ll will always cherish the spontaneous cards and baked goods I’ve received from patients over the years and the endless hand-shakes and thank yous. Or, the smiles on the many faces of kids as they leave the office realizing “that wasn’t so bad”. Or, when a family asks me if I’m accepting new patients, even though they know as an urgent care physician I don’t actually have a panel. One mom said to me “it doesn’t hurt to ask - again. May be you’ll change your mind someday.” Those are the gifts that keep me going. Those are the “right” kind of gifts.

But, like with teacher end of the year gifts, physicians need to be upheld to a very high ethical standard and it is about time we have an enforceable standards. Teacher gifts exceeding a certain amount actually have to be reported to the State Education Ethics Board. Physicians need a similar authoritative organization to fall back on. And, given what we do, I love the idea of a law!

Ending this wrong kind of gift giving in medicine will help us remove some of the junk and chaos in an already broken medical system so we can move on to other issues that need to be fixed - and we know there are others. The bill has passed the senate and is in the Massachusetts house.