Less money, More Problems?

Lauren Barnett, Compliance Specialist

The Huffington Post recently ran an article by Maggie Kozel, M.D., that raised the usual and customary issues involved with gifts physicians receive from the industry. Dr. Kozel believes the relationship between the industry and physicians does impact the cost of healthcare, and she praised the inclusion of the Sunshine Act in the healthcare reform law. One of the troubling areas cited in her article was the industry’s support of CME. While she does concede the industry has taken steps to separate support of these programs from marketing, she is concerned about the nuanced influence resulting from the physician speakers crafting their presentations around disease treatment, rather than prevention. The inference here is that the industry, which is about treatment, is influencing the doctors doing the speaking. She closes the section with the following:

“To justify industry insertion into the medical education process because educating doctors ultimately benefits the patient is like allowing soft drink vendors into schools because that will help fund after-school sports. The means shouldn’t run counter to the end.”

Call me crazy, but this sounds like Dr. Kozel is calling for the industry to be removed from CME. To this I ask, if the industry isn’t providing support, who will? According to a report from the ACCME, industry support has fallen for a third year in a row representing 37% of total funding. Additionally, advertising and exhibit hall revenues from companies are down as well. The study also points out that as industry support has dwindled, the number of programs available is dropping and attendance is rising. With CME being required by most states, I suppose physicians have no choice but to deal with what will be the rising cost of these programs.

Perhaps increasing the number of online programs would keep the costs reasonable. Of course this does not change the issue with the speakers. Asking CME providers to accept only speakers who have no financial relationship with the industry shrinks the pool of viable candidates to the point of being unrealistic.

I do agree with Dr. Kozel that transparency in the relationship between the industry and physicians is a good thing. That being said, eliminating industry support of CME is tantamount to cutting off your nose to spite your face. The industry has made great strides in separating the grant-making function from influence by sales and marketing. Thanks to the Sunshine Act, if people are concerned that a speaker’s remarks are being tainted by industry, they’ll have access to data on the payments that particular physician has received from a specific company. Completely removing the industry from CME simply does not benefit physicians and ultimately hurts patients.

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