Over the past 2 years, policies governing the relationship between physicians and pharmaceutical and device companies have undergone remarkable changes. A 2004 task force appointed by the American Board of Internal Medicine Foundation (ABIM) and the Institute on Medicine as a Profession (IMAP) found existing guidelines to be lax.1 At that time, the industry's Pharmaceutical Research and Manufacturers of America (PhRMA) Code ignored many salient issues, such as disclosure, speaker's bureaus, and ghostwriting and set only modest boundaries around dispensing food, gifts, and travel reimbursements.2 The American Medical Association's ethical guidelines largely duplicated PhRMA’s; however, on such practices as gift taking, it was even more permissive.3 The American College of Physicians acknowledged the influence of gifts on physician practices but did not prohibit them.4 Government bodies, including the Office of the Inspector General of Health and Human Services, essentially endorsed the PhRMA Code.5 Academic medical centers did not set a better example. Few of them had rigorous policies, and the exceptions received little notice.
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