w doctors is as unbiased as can be."

Other academic medical centers like Yale University and the University of Pennsylvania have also begun erecting barriers between sales representatives and medical staff and students.

Earlier prohibitions had already forbidden doctors from accepting gifts valued at more than $100 at most institutions, under guidelines from the American Medical Association. But only now attention has been given to the influence of free meals and smaller gifts.

"Giving a gift to someone creates an expectation of reciprocity," said Dr. Michael Steinman, a University of California, San Francisco.

He said ‘Even though it's subtle, it can influence decisions.’

Steinman added, "Lunch is the prototypical freebie."

Free meals at seminars, while seemingly insignificant, have become important to many time- and cash-deprived residents and medical students. Many couldn't find the time to attend the educational seminars without the meals, said Dr. Roy Poses, president of the Foundation for Integrity and Responsibility in Medicine.

Poses said, "Interns and residents work extremely hard and have no time. One of the few times they can sit down and listen to a talk is when they can eat lunch."

Dr. Larry Shuer, chief of staff at Stanford Hospital said it's common for industry salespeople to walk the hallways of hospitals, looking for an opportunity to talk with medical faculty and residents.

Shuer said, "These policies are to stop the industry reps from freely roaming the halls and pinning people down to grab a few minutes of their time."

According to Lassman, who is with the pharmaceutical industry trade group, stated that the new policies are unnecessary, as sales representatives must already comply with U.S. Food and Drug Administration regulations, in addition to industry guidelines on developing ethical relationships with health care professionals.

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