A Pox On Drug Maker Freebies, Say Some Doctors

Leuchter, who wrote the new policy, said medical students have been especially supportive.

"They come in very sensitized to the idea of industry influence," he said. "Some of us who have been doing this for years had become desensitized to it."

Some student activists became aware of the cause through an undergraduate ethics class or by reading some of the many recent books about drug company marketing. Many, including KirkHart, drew inspiration from the American Medical Student Assn., an independent, nationwide group of physicians in training.

The group launched an ongoing pharm-free campaign in 2002. Members signed a pledge to accept no money, gifts or hospitality from the pharmaceutical industry and to seek unbiased sources of information. The group invited medical students to turn in their drug-logo pens for ones bearing the slogan "No Free Lunch."

The debate has been vigorous even on campuses that have adopted new rules. At Stanford, for example, some students and instructors opposed the ban on drug samples, which had been used to treat low-income patients. The AMA magazine's article argued that such samples drive up healthcare costs by inducing physicians and patients to "rely on medications that are more expensive but not more effective."

Often the biggest controversy is the ban on free meals.

Dr. Tim Albertson, director of clinical care at UC Davis, said he has received many e-mails about food. "But for every one of those, I've gotten one that said, 'It's about time we did something. It's about time we make a stand.' "

At UC Irvine, which has not yet issued a policy, about 20 of 100 third-year students signed a voluntary pharm-free pledge.

"The typical reaction I get from my peers," said Boback Ziaeian, a pharm-free backer who helped circulate the pledge, "is, as medical students, we work long hours and are the lowest on the hospital totem pole. We should enjoy whatever we can."

Still, Ziaeian, who takes a big bag of granola to munch on during lectures, said he believes that the young idealists will prevail.

He recently shared a hospital elevator with a distinguished oncologist. The older physician noticed that Ziaeian was wearing a pharm-free pin and called him a modern-day Don Quixote.

"I hope that when the UC system institutes an extensive pharm-free policy like Stanford, Yale and the University of Pennsylvania, he'll realize that other, more influential people saw windmills too," Ziaeian said.

mary.engel@latimes.com