Breaking up is hard to do: Lessons learned from a pharma-free practice transformation

David Evans, Daniel M. Hartung, Denise Beasley, Lyle J. Fagnan

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Academic medical centers are examining relationships with the pharmaceutical industry and making changes to limit interactions. Most doctors, however, practice outside of academic institutions and see pharmaceutical detailers and accept drug samples and gifts. Little guidance for practicing physicians exists about transforming practices to become pharma-free. Consideration must be given to the impact on practice culture, staff views, and patient needs. Methods: A small private practice, setting out to transform into a pharma-free clinic, used a practice transformation process that examined the industry presence in the clinic, educated the doctors on potential conflicts of interest, and improved practice flow. Staff were given the opportunity to share concerns, and their issues were acknowledged. Educational interventions were developed to help providers keep current. Finally, efforts were made to educate patients about the policy. Results: The clinic recorded the degree to which it was detailed. Loss of gifts, keeping current with new drugs, and managing without samples were noted concerns. Policy change champions developed strategies to address concerns. Discussion: A shift in practice culture to a pharma-free clinic is achievable and maintainable over time. Barriers to success can be identified and overcome with attention given to careful gathering of information, staff input, and stakeholder education.

Original languageEnglish (US)
Pages (from-to)332-338
Number of pages7
JournalJournal of the American Board of Family Medicine
Issue number3
StatePublished - May 2013


  • Conflict of Interest
  • Drug Industry
  • Medical Ethics
  • Practice Management

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice


Dive into the research topics of 'Breaking up is hard to do: Lessons learned from a pharma-free practice transformation'. Together they form a unique fingerprint.

Cite this