No Free Lunch may be striking a nerve with professional societies

No Free Lunch has been knocking on the doors of exhibit halls at national doctors’ meetings lately. They believe the abundance of pharmaceutical company displays, gifts and “detailing” at these meetings could have a bad influence on doctors and would like an opportunity to do some counter-detailing, but so far the doctors have said “no, thanks.” Recently the American Academy of Family Physicians refused to allow No Free Lunch to operate an exhibit at its upcoming annual meeting.

Earlier this year the American College of Physicians (ACP) refused a similar request from No Free Lunch to exhibit at its meeting. The College has extensive pharmaceutical company displays and giveaways at its meetings in spite of its own position paper, which strongly discourages acceptance of gifts from industry. Evidently the No Free Lunchers merely wanted to remind attendees of the ACP’s own guidelines concerning the displays, so, banned from the exhibit hall, their supporters busied themselves outside handing out cards bearing a printed a summary of the guidelines. Apparently the ACP wasn’t amused.

Although the ACP position paper vaguely allows some wiggle room to consider acceptance of small gifts from drug companies, their former ethics director, Dr. William Golden, in a statement to American Medical News, once said "Our guidelines are slightly different than the AMA. We chose not to set a dollar value for a gift. We discourage all gifts.”

Founded in 1999 by internist Robert Goodman, M.D., No Free Lunch urges physicians to distance themselves from drug company marketing. I have followed their activities for several years. While agreeing with the basic premise of the organization I find some of their methods extreme. In the heated debate about physicians’ relationships with drug companies I take a moderate position, and have mixed feelings about the meeting exhibits.

The ACP can offer extraordinary educational content at its national meeting for an affordable registration fee only with the support of the pharmaceutical industry. Why throw the baby out with the bath water? On the other hand, if they choose to allow such elaborate promotions and freebies perhaps they should be more circumspect in their denunciation of them. As No Free Lunch has brought to light, the ACP has a credibility problem. They can’t have it both ways.