Save Certified Continuing Medical Education (CME).

Save Certified Continuing Medical Education (CME). Actions are now in motion by the AMAs Council on Ethical and Judicial Affairs (CEJA) and proponents to eliminate commercial support of certified CME. Industry sources currently account for over a billion dollars of financial aid to the CME system every year. Without public participation or dialogue the Council has proposed sweeping action which would eliminate over half of the CME available today. The resulting vacuum would likely be filled by a dramatic increase in promotional activities; specifically those intended to promote specific products and designed to bias prescribers to increase use of a product. These types of promotional education are not governed by the standards which separate promotional bias from education.

In a defensive move Pfizer recently announced that it will cease to fund accredited Medical Education Companies, limiting funding to academic medical centers, teaching hospitals and medical societies. Pfizer and proponents conveniently ignore that academic medical centers, teaching hospitals and medical societies receive 60 – 65% of their research grants from pharmaceutical companies creating a far greater hazard and potential for bias. The move is supposed to “mitigate(ing) the perception of a conflict of interest”. This is a PR tactic by Pfizer which similarly spent $13.8 million on lobbying efforts in 2007, the second highest by a pharmaceutical company (Center for Public Integrity).
Vote now to retain the availability and quality of certified CME.

“A review of literature on the relationship between commercial support and bias in accredited CME, commissioned by ACCME, found ‘No evidence to support or refute’ the assertion that support biases CME. The study was conducted by University of Georgia Department of Lifelong Education, Administration and Policy Chief Ronald Cervero.”

“A poll of 268 physicians found that 92% disagree with an American Medical Association (AMA) Committee’s call to end commercial support of CME. Respondents to the online poll, by Pri-Med, expressed a concern that a ban on commercial support would make it more expensive to receive CME and that the quality would decrease, making it harder for doctors to stay current and ultimately impacting patient care. ‘I don’t receive CME reimbursement from my employer’, said one respondent. ‘Any subsidy is very beneficial to me.’ The call to end CME was rebutted at the AMA House of Delegates meeting last month.” (MM&M, July 2008)

The North American Association of Medical Education and Communications Companies (NAAMECC) states that “The report mistakenly combines certified CME with “marketing” and other information included under the umbrella of “professional education.” Certified CME is not addressed specifically, and the report calls for elimination of industry funding of CME based on 22-year-old data that pre-dates the ACCME Standards for Commercial Support and federal government guidance requirements for producing high quality, industry supported education. In addition to blending CME with non-CME activities, the report misinterprets critical data in support of its recommendation, and it does not provide a tenable plan or evidence-based support for the transition it proposes.”

The American Association of Medical Society Executives (AAMS) has stated that “…eliminating industry funding of certified CME will marginalize the critical roles that industry, and many physicians working in industry, play in critical medical research. The practical impact of such a funding ban would greatly diminish not only the availability or quantity of certified medical education, but its quality as well. The scenario will not serve the needs or interests of patients and physicians, both striving to increase quality of care.”

The Council of Medical Specialty Societies (CMSS) has stated that “In short, the result of adoption of CEJA Recommendation 1 b) will likely be a rebalancing of education for physicians, with significantly less unbiased certified CME and significantly more biased promotional education.”

The National Task Force on CME Provider/Industry Collaboration, in reference to the CEJA Report, states that “Destroying much of the enterprise that improves physician competence and saves lives would not benefit physicians, patients nor the AMA; Indeed, the recommendations in this report are significantly out of step with the current and evolving law…”

References:
Drugmaker Lobbying hits record (www.NJ.com)
Poll – Docs: Don’t end CME Support (www.mmm-online.com)
AMA’s Council on Ethical and Judicial Affairs Report
The National Task Force on CME Provider/Industry Collaboration Responds to AMA’s CEJA Report
AAMSE Responds to the AMA’s CEJA Report
CMSS Responds to the AMA’s CEJA Report
Alliance Responds to the AMA’s CEJA Report
NAAMECC Responds to the AMA’s CEJA Report