MONTPELIER -- Vermont doctors are being shut out of events at regional and national medical conferences or professional association meetings when the companies sponsoring them offer a free lunch.
Signs outside events and seminars hosted by pharmaceutical companies and medical device manufacturers at conferences often say Vermont doctors aren't welcome.
It's a result of the state's so-called "gift ban," which is intended to regulate the influence of companies on the prescribing practices of the state's health care practitioners.
Vermont law prevents companies from handing out swag to win doctors' and other medical professionals' favor by banning most gifts and requiring the reporting of a wide variety of expenditures.
That's true for Vermont's doctors in state and out.
Hence the signs at conferences, which even appear on companies' displays in convention halls above baubles such as key chains or candy, according to Rep. George Till, D-Jericho, a practicing obstetrician.
There's a certain amount of retribution at work, Till said, from an industry that finds the state's regulation onerous and unnecessary.
Till was initially opposed to the gift ban, believing his decisions as a physician were not so easily influenced. But after seeing research showing that even seemingly inconsequential gifts or compensation could influence prescribing practices, he had a change of heart.
However, he hopes to pass legislation this session creating an exemption to the restrictions on food and drink provided at seminars and other events sponsored by medical device companies in order to allow Vermont doctors in the door.
"There are lots of ways to get reliable information about different pharmaceuticals without attending a company's event," Till said. But when it comes to medical equipment, "you really need to put your hands on it and see how it works."
Till introduced a bill, H.663, to address the problem at the start of the session, but it never made its way out of the House Health Care Committee. Now he plans to tack it onto S.252, an omnibus health care bill, or enlist the help of his Senate colleagues to add it to bills under consideration.
Vermont's gift ban statute has been updated several times since its passage four years ago, and exemptions have been added for educational materials for patients that may bear a company or product logo.
Till said that he did not think the exemption for medical device events is a departure from the law's principles, and does not create an opening for its opponents to push for further relaxation.
He said it addresses a practical problem for the state's doctors.
"Frankly, not every device manufacturer is going to send a sales rep to Vermont," Till said, "There's just not enough of us here," meaning that doctors sometimes have to attend events to learn about new equipment.
Massachusetts passed a gift ban law, which it has since watered down. A 2012 rule change allowed Bay State doctors to accept modest meals and refreshments from companies in any setting. Vermont's gift ban is more rigorous.
A provision of the Affordable Care Act, known as the Sunshine Act, will require data on payments and gifts made to physicians and teaching hospitals by medical device and pharmaceutical companies to be publicly available on a searchable federal database beginning later this year, but does not restrict these activities.
Vermont already has stringent requirements for companies to report to the Attorney General, but that information isn't available to the public in a searchable database.