There was some buzz yesterday after Dan Carlat, the gadfly who publishes the Carlat Psychiatry Report, wrote an op-ed piece in The New York Times calling Continuing Medical Ed programs a form of money laundering between drugmakers and doctors. A recent Senate report chastised the industry for not doing more to reduce fraud.

So we asked a sales rep to provide some feedback on this behind-the-scenes activity. Due to reasons of job security, anonymity was granted…

“I believe that companies are saying they take a hands off approach. I interviewed with an educational group and…they stated to me that they were being treated as a commodity like paper supplies. They told me there was one spokesperson who help identify the need and work the logistical issues, such as payments and contracts, but they were only to give very generalized education with no influence directly from the paying company.

“In principal that may work for primary care and broad health and wellness issues, but it’s very hard for companies when they want to promote or educate health care providers on something more specific, where they may have a leadership position or the only product for a particular illness.

“What many companies do is set up there own meetings with no CME’s and pay a consulting fee or contribute heavily to a particular academic institution, which has a mandate to do CME programs for physicians. This is where it gets tricky. The company gives an unrestricted educational grant or a charitable grant, or a research grant which then assumes a quid pro quo.

“You then have the crazy reps and medical science liaisons roaming about doing there own thing - paying providers, buying food. and other things that require monetary assistance. There is really no way to control the granting of money to large institutions, because they are generally in need of money, have loose controls, and especially urban centers, just look the other way so they get a good speaker who meets their requirement for CME’s and they do not have to fill out the paper to pay the speaker and they
usually get food paid for as an extra bonus.

“I do agree companies on the whole have very strict rules and if managemnt is ethical the rules are followed. I think one of the problems is when you have one company not following along that you feel compelled to break the rules to keep up….some companies still write paper grants, which would put others at a disadvantage and is why the backdoor payments and promotion of CME’s is a big target for all companies, but especially for the ones who don’t care about the policy of not compromising the programs.”