"Rules work only if they are obeyed"

I love that quote from an article in the Philadelphia Inquirer an alert reader (thanks, Debra!) sent me today. "Even after PhRMA passed new guidelines saying that free meals to doctors should be "modest," former HUP physician David Grande found in a 2002 survey that drug reps still invited HUP doctors to events 'at high-priced restaurants known to be among the best in Philadelphia.'"

That, and the logo'd pens and other gifties, are the reason why "several dozen drug company reps gathered yesterday at a Hospital of the University of Pennsylvania auditorium," the article says. They "weren't there to pitch drugs. They were trying to persuade the Penn system not to pitch them out." If everyone--and I'm not holding the docs blameless in the situation--involved just followed the existing rules, the reps wouldn't be in this pickle right now.

I've heard that rule quote in slightly different words from several of the people I've spoken with lately, only used in reference to the new ACCME Standards and guidance documents. As one gentleman said, "The ACCME can t enforce these new definitions in the guidance documents. They can t enforce what they already have how are they going to enforce this, which is so much more complicated?"

That would be a good question to ask of all the bodies that regulate CME and pharma: Why is there so much new rule generation going on, instead of putting all that time and energy into enforcing what we already have? I'm guessing the answer has something to do with time, money, and staffing, but I'd rather we spend that time, money, and staff-hours on enforcement than on lawyers who have to interpret the new rules or, in some OIG cases, negotiate settlements for violations.

But ultimately, the responsibility for change doesn't lie with the regulators; it lies with the rest of us. We can do better than this. Expecially if everyone takes it upon themselves to do the enforcing in their own offices and those of people they work with. As another person I spoke with recently said in regard to today's escalating regulations, "before you do anything, take a long, hard look at yourself. If you're looking at CME from a vendor perspective, you shouldn't be involved in it." Band-Aids won't help if the wound is systemic.

Isn't this all really just ethics 101?

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