The University of Pittsburgh Medical Center has written a prescription for integrity by cracking down on freebies and access by drug company sales representatives to its doctors and employees. But officials should rethink the idea of an all-out ban on accepting and dispensing free drug samples.

No one seriously will suggest that a doctor who takes a free ballpoint pen from a drug manufacturer's representative is going to use it to write unnecessary prescriptions. But the complimentary pens, notebooks and clocks are marketing devices, and when patients see them in a doctor's office, they give the impression that the doctor is endorsing that product. Have you ever seen a pen labeled "Jack Daniel's Tennessee Whiskey" or "Marlboro" at the office of your PCP?

The UPMC policy, as drafted, correctly says such gifts don't improve patient care, "may subtly influence clinical decisions and add unnecessary costs to the health care system."

Of course, the problem is much bigger than trinkets, so the proposed policy is extensive. It would bar UPMC employees from accepting tickets to sporting events and most meals and trips, as well as limit the circumstances when they can serve as consultants or be reimbursed for appearances. If adopted, it would apply to about 50,000 physicians and employees of UPMC and the University of Pittsburgh Schools of the Health Sciences.

The draft includes several prohibitions that are no-brainers. One is "consulting arrangements that simply pay [employees] a guaranteed flat amount without any associated duties." You might call that a payoff. Likewise, doctors could not have their names appear on papers ghostwritten by industry representatives. You could call that lying.

It also imposes some limits, though not enough, on the ludicrous practice of drug companies financing continuing medical education for doctors.

The troubling part of the policy is the proposed ban on doctors accepting or distributing drug samples. Unlike the other freebies, these drugs are for patients, not for doctors. The policy correctly points out that there are many drawbacks to the practice, but offering free samples sometimes represents the best way doctors can ensure their patients get needed medicine.

UPMC is investigating the feasibility of setting up a voucher program, which would allow patients to obtain free drugs through neighborhood pharmacies or get help through drug manufacturer assistance programs. Some community practitioners, though, worry those approaches will be too cumbersome. For a doctor who wants to be certain patients get needed medicine, there is no surer way than handing it to them.

The Henry Ford Health System in Detroit still allows its doctors to provide samples, but it regulates the practice. Drugs are kept by approved clinics, not in individual doctors' offices, and nurses check the samples monthly to make sure expired drugs are discarded.

Another model might involve a central repository for the samples, with a hospital committee that would allocate drugs by matching them with doctors' offices that see the most low-income patients who need them.

UPMC is not the first medical system to consider imposing restrictions on the influence of drug or medical device companies. With a sound policy, it can be the system that provides the best cure.