The Canadian Medical Association is being criticized for agreeing to accept $78,000 in funding from Pfizer’s Canadian subsidiary to create continuing medical education programs (here is the CMA statement). Several prominent physicians argue the CMA may cross ethical lines in ways that could negatively influence treatment decisions.

“Partnering with a pharmaceutical company sends the wrong message to doctors – that we don’t have to pay for our continuing education, that it’s the responsibility of others. This is unlike how any other profession deals with continuing education,” Joel Lexchin, a health-policy professor at York University in Toronto, tells us.

“The sponsorship provided by Pfizer sets up a ‘gift relationship’ between Pfizer and the doctors who take part and between Pfizer and the CMA. Once having received a gift people feel obligated to respond although usually that feeling is subconscious,” he continues. “And when drug companies are involved in sponsoring CME the range of topics is narrower than when doctors are paying for their own CME and the focus is much more on pharmacotherapy.”

The uproar occurs more than a year after Pfizer altered its CME policy to support continuing medical education courses at academic institutions, teaching hospitals and those supported by medical societies, but no longer directly support CME courses offered by for-profit medical-education and communication companies (see back story).

Ironically, the editor of the CMA Journal argued in an editorial last year that industry-funded CME is “unacceptable” and a major overhaul is needed to erase industry influence, The Toronto Globe & Mail points out.

“Physicians are seen as being aligned with the pharmaceutical industry and with its commercial priorities,” Paul Hebert wrote. “We seem to have conveniently forgotten that the pharmaceutical industry is in business to make money, not to educate health professionals.” (full editorial here). Hebert emailed the Globe & Mail to say the CMA and journal are separate, and declined further comment. ”

Here’s the deal: Pfizer Canada will provide $780,000 to fund the new CME program. Two Pfizer staff members will also sit on an administrative board, responsible for overseeing, implementing and evaluating the program, along with two CMA staff members and two individuals from outside organizations.

Sam Shortt, director of knowledge transfer at the association, tells the paper that Pfizer will have no say in how the CME content is developed. They will also follow ethics and transparency guidelines created separately by the CMA and the industry trade group, the paper writes.

“There’s no connection between the funder and the people who are actually providing the content,” Shortt tells the paper. “We’re confident that these two elements meet and exceed any expectations from any observer.” A Pfizer spokeswoman tells the paper that the drugmaker’s only aim is to “improve education that’s provided for doctors across Canada.”

And Arnold Relman, professor emeritus at Harvard Medical School and former editor of the New England Journal of Medicine also tell the Mail that “it’s simply a matter of common sense that if Pfizer is going to pay the Canadian Medical Association for medical education to doctors, Pfizer expects to get something in return.”