Casey KirkHart was in many ways a typical medical student, which is to say he was usually hungry, always pressed for time and keenly aware of his mounting loan debt.
Unlike many of his peers, however, he routinely passed up the lunch that accompanied a weekly lecture, even though the food was everything a student could want: tasty, convenient and, thanks to the pharmaceutical company that catered it, free.
After getting "weird looks" from peers and instructors alike, KirkHart, then at the New York College of Osteopathic Medicine, put together a PowerPoint presentation to explain why. Using charts and graphs, he cited studies showing that about 90% of the drug industry's $21-billion marketing budget went to physicians and that all those mugs, meals, drug samples and speakers' fees influenced doctors' prescription decisions.
He slipped in a photo of himself dressed in a white doctor's coat plastered with enough drug-company logos to rival a NASCAR race driver. The caption read: "The White Coat of the Future?"
KirkHart is now a second-year resident at Harbor-UCLA Medical Center, and the future is starting to look a little different.
The "pharm-free" movement he championed is spreading around the country in the wake of an article in the Journal of the American Medical Assn. challenging academic medical centers to ban drug industry freebies.
In October, Stanford University Medical Center, following Yale University and the University of Pennsylvania hospitals, barred students, faculty and medical staff from accepting even small gifts. UC Davis passed a similar policy late last year that is to take effect July 1.
UCLA's David Geffen School of Medicine approved one in November and sent it to its affiliated hospitals and clinics for a final review. The guidelines, expected to take effect by the end of the school year, will be among the toughest in the country, stripping all clinics and hospital buildings of pens, pads, clipboards and calendars bearing any signs of drug promotions.
And the UC Office of the President is working on systemwide rules for its five medical schools.
"It's not fringe people," KirkHart said. "These are reputable, world-class universities. There's a real culture change happening. We're going to wean ourselves off drug money."
But Scott Lassman, senior assistant general counsel to the Pharmaceutical Research and Manufacturers of America, a marketing and lobbying group based in Washington, D.C., called such restrictive policies "unnecessary and an overreaction."
