Drug Samples, Universal Access Top Issues at Resident, Student Congresses

By Leslie Champlin & Jane Stoever • Kansas City, Mo.
8/14/2006

Family medicine residents and students are asking the AAFP to help physicians close their drug closets without closing the door to low-income or uninsured patients. To that end, they adopted resolutions on the issue here during the National Congress of Student Members and National Congress of Family Medicine Residents.

Pharmaceutical Marketing

Residents need resources to teach them to teach, says Molly Cohen-Osher, M.D., of Berwyn, Illinois. She was a co-author of a resolution the residents passed that asked the Academy for an interactive, online learning tool on teaching.

Residents and students requested that a workshop be offered during the 2007 National Conference of Family Medicine Residents and Medical Students to describe alternatives to accepting and distributing pharmaceutical company-provided samples.

Passage of this and other pharmaceutical-industry-related resolutions in the two congresses came after debates on whether a ban on free samples would prevent low-income or uninsured patients from gaining access to needed medications.

"Samples are a staple for us," said student Jessica Diggs of Cleveland. Refusing pharmaceutical samples, she said, "might be ethically sound, but it has a substantial consequence to free clinics and the underserved population."

"Samples feel like a solution in the short term," said student Jonah Stulberg of Cleveland. "But we're not helping patients by giving them drugs that won't be there in a month."

"We should free ourselves of this process (using samples) that could be detrimental to patients' care," said resident Casey Kirkhart, D.O., of Los Angeles. "In receiving the newest medications, we relinquish what may be evidence-based care."

The residents asked the AAFP to encourage physicians and residency programs to seek alternatives to accepting and distributing samples.

Equal Access, Rights

Residents and students adopted several resolutions addressing patients' access to care and the rights of patients and health care professionals. Among them:

A resolution passed by students asks the Academy to "investigate and discouragehealth care charge discrepancies between insured and un/underinsured patients."
Both congresses passed measures calling on the AAFP Task Force on Health Care Coverage for All to consider a single-payer system as a viable option for health system reform. Resident Catherine Anderson, M.D., of Kansas City, Mo., supported the resolution, saying, "Canada, Japan, Switzerland and other countries operate a national health program, and it's not the fearful thing we think about. These other countries have far better outcomes even though they spend one-third to one-half less than we do per person."
Parallel resolutions passed by both congresses ask the AAFP to make comprehensive health system reform -- including workforce, liability and payment reform -- a matter of the highest priority. "We as family physicians provide the bulk of primary care in this country," said resident David Johnson, M.D., of Reno, Nev. "We should be leading the charge on this issue. We need to send a message that health system reform should be made the highest priority of our Academy."
A resolution passed by students calls on the Academy to oppose any legislation that would "criminalize physicians who provide care to undocumented patients," as well as any that would require "health care providers to collect and report data regarding a patient's legal residency status."
Residents passed a resolution that asks the AAFP to oppose any legislation that would give federal or state governments “the responsibility to regulate appropriate medical practice through the use of criminal penalties.”
Another measure passed by both congresses asks the Academy to issue a statement of support for parental rights of gay, lesbian, bisexual and transgender adults and to advocate legislation that supports such rights.

Other Issues

Students and residents discussed a variety of other issues during the meeting. Delegates to the two congresses asked the Academy to look at public health programs, health literacy and cultural diversity. They also asked the Academy to examine the possibility of funding more international experiences for residents and students, and they considered several resolutions related to reproductive health care.

The AAFP Commission on Education is reviewing the adopted resolutions, which will be forwarded to the AAFP Board of Directors or Academy commissions. The resolutions will be available by late August at the National Conference Web site.

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