The AMA Decides Not To Ban CME Funding
8 CommentsBy Ed Silverman // June 16th, 2008 // 1:05 pm
UPDATE as of 4 pm: The American Medical Association’s house of delegates this afternoon decided a proposal to rid medical education of industry funding needs more review. The controversial proposal was made by the AMA’s Council on Judicial and Ethical Affairs to end pharma funds for residency positions and clinical fellowships; educational programs, such as live or web-based CME; physician speakers’ bureaus; and travel, lodging, and amenities for CME participants.
Other recommendations include a ban on industry gifts, meals and detailing at med schools, and an unspecified effort to secure non-commercial funding sources. One exception was suggested for training in new diagnostic or therapeutic devices and techniques, because industry reps may have to play an educational role as the only available teachers. However, once expertise is developed, the committee maintains industry involvement is “no longer warranted.”
In explaining the proposal, the committee writes “To promote continued innovation and improvement in patient care, medicine must sustain ongoing, productive relationships with the pharmaceutical, biotechnology, and medical device companies. However, industry support of professional education has raised concerns that threaten the integrity of medicine’s educational function.” Here is the summary.
The proposal was already controversial before the AMA convention began this weekend in Chicago, and a reference committee yesterday passed along the proposal to the house of delegates with a recommendation that the topic should be reviewed still more, rather than adopted. And so the house of delegates did just that - they opted for still more review, an AMA spokeswoman tells us.
Dan
Doubtful in a complete sense. The two are in collusion, as ultimately the AMA provides the data that reps use to manipulate docs, after the pharma companies pay the AMA a great deal of cash for this data release.
Ed Silverman
Hi Dan
I just updated and the AMA voted the matter needs still more review.
Regards
ed
Paul G
The reality is that the CEJA based its arguments on very outdated data and without taking into any consideration what has transpired in the last 10-12 years to clean up things.
Sounds like they got a good smackdown and probably feel sorry that they had been hijacked by The Prescription Project and others to stick their necks out.
Congratulations to the AMA for going down the path of reason.
HorusCat
It never fails to amaze me how smart academics think they are (we’ll use the reps to learn the new technology, then we won’t need them). The academics with whom I interact pepper me with questions about my products–from dosing to side effects to formulary access. The really smart ones know that they can keep up with most things–especially those right in their specialty–but drugs have multiple indications across a broad spectrum of disease, and they can’t keep up with everything. They also know that they get into habits–and may not push themselves to learn everything about new products and technologies.
I am not sure where these anti-pharma docs think the money will come from. No doubt they feel no compunction about stealing from my paycheck to educate themselves–they can sanctimoniously proclaim themselves free of conflict as they conscript my labor to fund their self-righteousness. I’ll gladly pay more in taxes to fund medical education when those pious SOBs help pay my mortgage and put food on my table.
HorusCat
And Dan, that self-righteous attitude includes you, too. No doubt you believe the government should become even more of a nanny than it already is, stealing the private property of the individual to assuage your private definition of morality.
harpy
I agree with you, Dan. I’m surprised CEJA recommended it in the first place. Maybe they had to justify the “ethical” part of their name. Or they’re trying to show they’re “with-it” as the kids say.
RAT
I think Dan’s comments are ludicrous.
It never ceases to amaze me how a group of learned individuals come up with solutions which essentially have no solution or are completely farcical and a waste of paper.
Look for more sources of non commercial funding? Is this what I read? If a medical school or physician organization went to the American Dairy Association to obtain a ” educational grant” for example, for the very reason they are not a pharmaceutical or device company- the first question from the Dairy Association would be “OK, what’s in it for us?”. I am amazed at how naive academics can be. To expect there to be “non commercial” interests to support their education? All business is commerical, no matter how you cut it.
Do doctors work philanthropically in their practice of medicine? My bet is are they take every dime they can, for every service they provide.
I think the solution is to take the industry funding, use it wisely through development of a good set of CODE regulations which govern how the industry support is used, and to allow the creation of good, learning programs, which are balanced in scope, peer reviewed, consistent with a solid evidence base, and are current and topical. They can continue to use ethical third party providers who have shown exemplary skill in development of programs and are not in anyway in collusion with pharma (marketing and/or sales) This way everyone wins, and doctors continue to hone their skills, fill their pockets because they have enhanced their knowlege of current medicine and can treat patients more optimally, and the commercial interests can feel good about being part of the process in terms of brining new and relevant information to bear, even if its relate to their product in a balanced fashion.
And to suggest that a rep is good for training and then disposable is an affront and a reprehensible approach to all those companies whose interest is not only to “make money” which is entirely understandable, but to advance the cause of medicine at large.
I think that medicine has been well served by enlarge by commercial funding, and I would suggest that those who have attended post graduate training for many years and consider themselves puritans take another look at their bank balances and Porsches sitting in the doctor’s parking lots before dissuaging commerical interests.
Without pharma and drug companies and the advancements they have made to medical science, most doctors would sit behind their desks twiddling their thumbs, not being able to offer their patients much in the way of hope, in particular with life threatening diseases.
Don S., MD
Pfizer was fined $430 million for their indiscrimate promotion of an anti-epileptic drug Neurontin for neuropathic pain in the US, as it was not disclosed in the CEJA report
They recently came out with a resolution to discontinue funding to healthcare communication companies to insure they set the “standard for the highest level of CME”, and will fund academia and medical organizations only.
PR is what I call it. Redemption I don’t. I haven’t seen any other companies jump on board after their “announcement” to match Pfizer’s surprisingly “ethical standards.” Pfizer’s approach to this is nothing but a way to suddenly set the bar when they have been the biggest culprits in providing promotion to doctors in the abscence of good education.
They need to get real and just develop programs with solid ACCME criteria, stay out of the development process and they’ll still win out, as they have to be the biggest pharmaceutical money making machine in the world. They still can work with the medical community, they don’t need to create PR buzz to show how “clean” they are.
Its BS in my books.
I’ve been to many industry sponsored events, and have learned much. In fact I stay abreast as much as possible, using industry, academia and organizational funded programs. It makes me a better doctor. The problem is the FDA and government dont realize at the end of the day, I’ve got enought education (pre and post graduate) to the degree where I can make my OWN independent decisions on what to prescribe, where and when, with full knowlege of what has been commercially pushed at me, and what has been balanced, fair and useful to me in my practice.
The Government should stay out of what doctors choose to learn and how they go about it.
I endorse funding from commercial sources, primarily because without them, its difficult to get enough good CME, and I feel confident enough in my abilities to discern whats promotional and what’s educational.
Every doctor should fit into this category, if they think about it, even Dave Davis, who in the Pfizer announcement commented on this ‘advancement” and lauded Pfizer for their actions.
Doctor’s are intelligent people. Let us decide for ourselves how we continue to upgrade our skills. Dont mandate our interaction with any facet of medicine, including industry.