Carilion Clinic Implements New Policy to Improve Patient Care
New policy regarding pharmaceutical and medical device representatives is designed to support the physician-patient relationship
ROANOKE, Va. (Feb. 23, 2010) – In an on-going effort to advance the quality of care we provide our patients, Carilion Clinic will follow the lead of some of the country’s most respected medical institutions and improve the way we manage our relationships with pharmaceutical and medical device manufacturers. The new policy, developed after more than a year of consideration, is intended to provide vendor representatives with continued opportunities to share valuable information, without the appearance of improperly influencing care-giver’s decisions.
Carilion’s new policy is similar to those implemented by the University of Virginia Medical Center, Geisinger Health System, and the Cleveland Clinic. It is also in line with recommendations from the American Association of Medical Colleges and the Joint Commission.
“Nothing should interfere with the relationship between a doctor and his or her patient,” said Tony Slonim, M.D., Carilion Clinic’s Vice President for Medical Affairs. “We put the needs of our patients first, and want them to feel confident that we are making decisions based on their best interests.”
The new policy was developed based on the following:
- Quality, effective and efficient care is our top priority.
- Information provided by pharmaceutical representatives generally promotes newer, more expensive medications that may not always offer a significant advantage over existing, lower cost alternatives. This can drive up the cost of care, contrary to Carilion Clinic’s stated goal of cost reduction.
- The distribution of medication samples is largely uncontrolled and undocumented, making recalls and other issues difficult to manage.
- Pharmacies are the best option to manage the distribution of medications to patients.
- Our physicians’ office time should be spent with patients, not with drug and device manufacturers’ representatives.
- The presence of representatives and branded gifts and paraphernalia sends the wrong message, and can leave the impression of improper influence on care decisions.
The new policy takes effect throughout the Carilion system on July 1, however several locations are already implementing the new guidelines. Key components of the new policy include the following:
- Visits by vendors are by appointment only, and limited to non-patient care hours.
- All vendors must be registered through Carilion Clinic’s Corporate Purchasing Department.
- Vendors will be issued a temporary visitor’s badge and must wear the badge at all times when on Carilion property.
- Vendors are not allowed in patient care areas, and may not be present during patient appointments.
- All gifts, food and meals from vendors are prohibited.
- Carilion physician practices will no longer accept or keep medication samples from pharmaceutical representatives.
As an alternative to medication samples, Carilion Clinic physicians will prescribe generic medications (available from retail pharmacies for $4.00) whenever possible, encourage pharmaceutical representatives to provide vouchers that can be used to obtain a free supply of medication from pharmacies and maintain current information about assistance programs provided by pharmaceutical companies.
This new initiative is just one aspect of Carilion Clinic’s mission to constantly improve they way we care for patients.
7 Responses to “Carilion Clinic Implements New Policy to Improve Patient Care”
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dingle40 on February 24th, 2010
What exactly is the aforementioned policy. This post does not give the details?
Gail Tankersley on February 24th, 2010
I have been working as a nurse in physicians offices since 1995, and have always been thankful that I could supply patients with samples. I truthfully think removing samples from the offices is one of the worst ideas to come along. Patients often want to try a sample medication because of 1)seeing if it is something they can tolerate, 2) cost – often they are poor or inbetween paychecks, and barely have enough money for the physicain’s bill, and 3) May only need a few days worth until they can get their next prescription filled or are waiting for their mail order meds to arrive. I honestly don’t see how removing drug samples is something that they patients will see as “quality, effecient or effective” healthcare or not interfering with the care they receive from the physician. I can understand removing lunches and dinners, and honestly like the idea of seeing drug reps by appointment, but please, reconsider the samples. Don’t make the patients suffer, or the doctors be unable to try new medications. We live in a time that we need to help each other, that we need to relize that for some even $4 is a lot and that possibly someone will have to choose between milk and bread or the $4 medicine. Please reconsider this. Carilion is supposed to be about “patient first”….where has that gone?
Carilion Clinic on February 24th, 2010
Thanks for your comments Gail, and I understand your concern. The issue is not just money, but safety. Distributing drugs from a sample closet is simply not the best and safest way to dispense medication. We understand that samples can sometimes be helpful for a patient to evaluate a medication, or to tide them over when they have financial difficulty. That is why we’re asking the pharmaceutical reps to provide us with vouchers that we can give to patients, allowing them to get free or discounted samples from a local pharmacy. That way the patient’s needs are met, the pharmaceutical rep’s needs are met, but in a safe way.
Carilion Clinic on February 24th, 2010
Hi Dingle,
Read about two-thirds into the post and you’ll see highlights of the policy listed.
Tammy on April 19th, 2010
I have been a patient of a participating carilion physicians for 20 years. About 2 years ago, I was put on medication for high blood pressure. I tried all of the generic or lower priced brands as I always ask for generic. Unfortunately, I kept a headache with all of these brands and my physician told me he thought it was a medication intolerence. Sure enough he gave me samples of a name brand medication and I have been on this medication since. When my husband lost his job of 21 years, there simply was not enough money to pay $50.00 per month for medicine so I stopped taking it. My blood pressure went crazy. My physicians has been giving me samples and I am very greatful, because this was the only way I could continue taking my meds. Now, I guess I will just have to do without them since there will be no more samples. I hope nothing happens to me without my meds. My children need me to be around for awhile yet.
Carilion Clinic on April 20th, 2010
Sorry to hear that you’ve been having problems. Please speak with your physician about this as soon as possible. We are asking pharmaceutical representatives to give our physicians vouchers that patients can use to obtain a free medication sample from a pharmacy. However, the pharmaceutical companies have never intended samples and vouchers to be used to assist patients who can’t afford their medication on a long term basis. The major pharmaceutical companies have programs that provide free or discounted brand-name medication to people who can’t afford it. Talk to the staff in your physician’s office about applying for a program that includes the medication you are using.
pmvari on April 23rd, 2010
We are finally at a place in time where breastfeeding is recognized indisputably as the infant feeding method that provides the foundation for a healthy life. Research has also shown that providing infant formula or even items with formula company logos to families can negatively impact breastfeeding success. Just as giving out free drug samples and having gifts that display drug company logo sends a message that improper influence may have been exerted to health care providers, so to, does giving out free formula and displaying items with formula company logos. Giving out free formula and displaying formula company logos not only goes against the new policy, but also sends a message from trusted health care providers of recommending an inferior product. I hope that the response to this email will be that the new policy applies to infant formula. Infants are our most vulnerable population of patients. As trusted health care providers, we need to especially care for and protect those that have no voice.