N.J. could be first to target doctors who accept industry gifts

New Jersey physicians would have to refuse lunches from drug reps and publicly disclose any industry payments of more than $200 as conditions of licensure if new recommendations from the state attorney general's office are adopted.

The proposals were among 22 recommendations included in a Dec. 3 report to Attorney General Anne Milgram (link).

The report also recommended the state medical board require that 25% of continuing medical education credits should come from "evidence-based educational programs" that refuse industry grants. Also, doctors would be barred from claiming authorship for articles they did not write and from misrepresenting their financial interests on disclosure forms.

While a handful of states have fought financial conflicts in medicine by regulating drugmakers and threatening hefty fines, the proposals would make New Jersey the first to make doctors the targets of enforcement.

The proposed regulations "are designed to ensure that patient care is guided by the unbiased exercise of doctors' best judgments," Milgram said in endorsing the report's proposals. "It is critical to minimize the potential for conflicts, and it is critical that patients are made aware of any financial relationship between a physician and a pharmaceutical company or medical device manufacturer. Such relationships could bias medical decision-making."

The report calls the regulations "complementary reforms" meant to buttress the Pharmaceutical Research and Manufacturers of America's voluntary code on interactions with physicians that took effect in January. There are about 33,000 physicians licensed in New Jersey.

The Medical Society of New Jersey said the proposals unfairly put the regulatory onus on doctors instead of drugmakers, while neglecting how health plans also strive to influence prescribing decisions.

"It just sometimes feels like you're being slapped in the face when the attorney general says, 'Here, it's your fault,' " said Donald J. Cinotti, MD, president-elect of the state medical society. "I know for a fact, when I see a drug rep, I don't say, 'Hey, where's my lunch?' "

The recommendations were presented to the state's boards of pharmacy and medicine for consideration. The New Jersey State Board of Medical Examiners did not respond to American Medical News inquiries by this article's deadline.