Archive for August, 2009
CME on the Web: Week of August 20th
So here is a sample of what is on the web and in the news abut CME this week
What do you know -a “good news story on the Web about one of our own.
Continuing Medical Education with Poetic Style: Outcomes Inc. Founder & President Grows Successful Business and Finds Fulfillment in Poetry
As president of Outcomes Inc.—an $9 million business focused on continuing medical-education assessment—and a published poet, Linda Casebeer has proven that taking risks and persevering are keys to success. Her experiences in the start-up phase of her business are valuable to any entrepreneur looking to overcome initial hurdles. Whether seeking business success or personal fulfillment in artistic expression, Linda’s journey is one of full of satisfaction on many levels.
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How to make industry influence transparent in continuing medical education
Medical Weblog. KevinMD.com
August 25, 2009
Here is how this one starts:
“A recent hearing of the Senate Aging Committee on continuing medical education (CME) should scare anyone who might need to see a doctor in the next few years. But you don’t need to be a Washington policy wonk to discover that there’s a huge problem with CME.”
Why We’re Opposed to Medical Ghostwriting
Posted by Erik Deckers on Aug 25th, 2009
Since many MECC’s are involved in this practice you might find this interesting. Here id how this one starts:
“We’re opposed to this kind of ghostwriting, because it’s dishonest, unethical, and presents all kinds of conflicts of interest.”
OIG Chief Counsel testifies on ensuring CME integrity
CCH® Healthcare Compliance — 08/25/09
NOTE: You really want to read this one.
“The commercial sponsorship of continuing medical education (CME) poses a potential conflict of interest between patient welfare and the commercial interests of sponsors, according to the testimony of the Office of Inspector General (OIG) Chief Counsel, Lewis Morris. Sponsors that provide funding to CME providers are frequently manufacturers of drugs, biologics, or medical devices related to the topic of the CME program. Commercially-sponsored CME programs consequently tend to focus more on sponsors’ products than do programs that are not commercially-sponsored. One study on pharmaceutical promotional strategies revealed that spending $1 on physician events generated an average of $3.56 in increased revenue.”
Testimony before the Senate Special Committee on Aging, July 29, 2009
How to make industry influence transparent in continuing medical education
In: Daily Health Scope August 25th, 2009
Read this recommendation.
“This could be achieved, like so much else these days, through an internet website. The site, CME.Gov, would be run by the National Institutes of Health and would serve as a central repository of all significant information for CME programs. It would require all CME supporters, producers, and participants to fully disclose complete information about the funding and the content of their programs. No CME credit could be earned unless all the required information about the CME program were first registered on CME.Gov.”
Carlat’s Blissful Deception
Policy in Medicine, August 28th 2009
Daniel Carlat, MD will go to just about any lengths to discredit medical communications companies, he even once set up a website (at 2:00 in the morning) to parody the Association Clinical Researchers and Educators. This time he has gone overseas to give an example of a problem medical education company in a story titled: A MECC that BLISSfully Keeps Promotion in Medical Education
University of Wisconsin CME: Dean Directs Sunshine on Journal Sentinel Attacks
Policy in Medicine, August 30, 2009
In this weekend’s Milwaukee Journal Sentinel, Robert N. Golden, MD dean of the University of Wisconsin-Madison School of Medicine and Public Health and vice chancellor for medical affairs sets the record straight on their CME program. Contrary to articles written in that paper that attempt to discredit the program the school shows that after significant review the CME program at Wisconsin is above reproach.
Add comment August 31, 2009
CME In Web News Week of August 17th, 2009
Here is some of what the public is reading about CME in the papers and on the web this past week.
From the Web Page of the Senate Committee on Aging
KOHL HEARING CONSIDERS EFFECTS OF BILLIONS IN DRUG, DEVICE FUNDING ON MEDICAL EDUCATION IN AMERICA July 29, 2009
The report begins:
“The U.S. Senate Special Committee on Aging Chairman Herb Kohl (D-WI) held a hearing on conflicts of interest in medical education. In recent years, the pharmaceutical and medical device industries have increased their funding of Continuing Medical Education (CME), medical schools, and professional medical associations. The industries also pay physicians directly for their service as educational consultants. According to the Institute of Medicine, industry funding for accredited CME quadrupled from $302 million to $1.2 billion between 1998 and 2006.
“Large corporations do not typically spend these sums unless they think they will get something out of it,” said Chairman Kohl. “Are the drug and device industries getting a return on their annual billion dollar investment in medical education? Do the programs funded by industry stay true to their mission of providing unbiased education and research, or do they instead market the industry’s latest products? We are not suggesting that these financial relationships are rife with corruption, but it is clear to us that greater transparency, and perhaps stronger firewalls, should be considered.”
Read More:
Medical schools and drug companies too cozy
Milwaukee Journal Sentinel
Last update: August 18, 2009 – 3:19 PM
The University of Wisconsin CME office takes another slam from the press. Here is the last paragraph of this article.
“The University of Wisconsin’s good name has been tarnished by this money-grubbing enabling of a drug company’s marketing campaign. In recent months, the school has taken steps to establish tougher conflict-of-interest rules. But UW hasn’t moved to limit continuing medical education payments from industry, which may be an even larger risk to its reputation.”
Senator Moves to Block Medical Ghostwriting
By NATASHA SINGER
New York Times
Published: August 18, 2009
Many CME providers have experienced the practice of “ghostwriting”, especially in the preparation of enduring materials. The practice is under fire.
A growing body of evidence suggests that doctors at some of the nation’s top medical schools have been attaching their names and lending their reputations to scientific papers that were drafted by ghostwriters working for drug companies — articles that were carefully calibrated to help the manufacturers sell more products.
JAMA
Vol. 302 No. 7, August 19, 2009
Industry Support and Professional Medical Associations
Letters published from several people in response to the JAMA article appearing April, 2009 calling for drastic changes in industry support for medial education.
Full access to these letters requires a subscription to JAMA, But here is the first part of several of the letters.
To the Editor: In their Special Communication, Dr Rothman and colleagues1 noted that “extensive literature has documented the influence of gifts on individual physicians.” To my knowledge, there is no similar evidence showing that commercial support of continuing medical education (CME) has the same influence, either on physicians or on their professional medical associations (PMAs).
The best current evidence is a study commissioned by the Accreditation Council for Continuing Medical Education (ACCME) and not published in the peer-reviewed literature.2 Additional high-quality evidence in this area would add to this already valuable national discussion.
It is critical to recognize the implications of the difference between relationships of individual physicians with industry and grants from industry to PMA’s for independent CME. Based on the evidence, few of the authors’ recommendations follow convincingly. One which does, however, is that committees crafting clinical practice guidelines should be composed of members without ties to industry, . .
Norman Kahn, MD
nkahn@cmss.org
Council of Medical Specialty Societies
Chicago, Illinois
Industry Support and Professional Medical Associations
To the Editor: In their Special Communication, Dr Rothman and colleagues1 made a number of suggestions to control the real and perceived conflicts of interest encountered in PMAs. Regarding industry support of conferences and other educational meetings, they recommended that “each PMA might establish a CME committee whose members, free of all industry ties, would have the responsibility to distribute unrestricted, educational grants from industry.”
Such a model already exists and has been active for more than 2 years. The collaborative grants model developed by the Physicians’ Institute for Excellence in Medicine (PIEM, a subsidiary of the Medical Association of Georgia) does just that.2 Grants are solicited from industry; in turn, these are distributed through a request-for-proposal process to 14 state medical societies. A committee of physicians in each society decides which of the applications from their state should be sent forward to PIEM for a final decision. Industry plays . . .
Walker L. Ray, MD; Robert L. Addleton, EdD
bob@physiciansinstitute.org
Physicians’ Institute for Excellence in Medicine
Medical Association of Georgia
Atlanta
1. Rothman DJ, McDonald WJ, Berkowitz CD; et al. Professional medical associations and their relationships with industry: a proposal for controlling conflict of interest. JAMA. 2009;301(13):1367-1372.
You may want to read the response to these letters by Dr. Rothman.
University Diaries Blog
August 18th, 20029
By Margaret Soltan who is an English professor at George Washington University, in Washington, DC.
“This money-grubbing enabling of a drug company’s marketing campaign…” … should really stop, writes the editorial board of the Milwaukee Journal Sentinel.
Especially since the grubber in question is the University of Wisconsin’s medical school, which got a million dollars from a drug company to put UW’s good name behind the company’s synthetic testosterone.
Said testosterone is not only of uncertain benefit to men older than 45; it might actually be dangerous. But its maker, Solvay, touted it on a continuing medical education website which offered CME credit to doctors who read articles on the site about it. And, since a real live university sponsored the deal, the medicine looked legit.
Industry funding of continuing medical education should be phased out to avoid conflicts, and Congress should require full disclosure of all industry payments for continuing medical education.
Phasing out industry funding of CME means phasing out CME, at least as we’ve come to know it.
Another read on this comes from an Association for Healthcare Journalist blog.
Why Most CE Courses are Dead on Delivery
By Keith Eric Grant, PhD, NCTMB
Massage Today
August 19, 2009
Here’s one from a person involved in massage. A look at some of the literature about the effectiveness of CME.
Careers in CME (continuing medical education)
Trusted.MD
8/21/2009
Here is an interesting comment on careers in CME and the future of industry support for CME. Might give you pause.
Add comment August 24, 2009
CME and Issues We Care About in Cyber-News
I watch the web for things reported about or of interest to the CME community. Recently it hasn’t been very good news. A few weeks ago there was a flurry of items reporting on the Senate hearing on bias in medial education. Lots of finger pointing at the influence of industry on the continuum of medical education and medial research. There was even one call to abolish ACCME. Hmmmmmm. Now there is a thought. It’s not a good idea but a thought. So in the past few days the following items appeared in cyber-news. These articles are the face of CME to most of the public. Not much if it is what I want people to focus on related to my efforts to support physician lifelong professional development.
South Florida doctors paid thousands by Eli Lilly
Miami Herald
August 8, 2009
While policymakers question whether drug makers are hurting healthcare reform by paying doctors fees, Eli Lilly revealed that it paid 10 South Florida providers more than $10,000 each during the first quarter.
Read more here.
Industry gift bans slammed for overreaching
American Medical News
August 10th, 2009
Kevin B. O’Reilly, AMNews staff. Posted Aug. 10, 2009.
Pressure is mounting on Capitol Hill to reveal the financial relationships among doctors, drug companies and device makers through the Physician Payments Sunshine Act.
Six states already have enacted payment-disclosure laws or bans on gifts to doctors. Meanwhile, more medical centers are restricting doctors’ and students’ interactions with industry, as calls grow for medical societies and educators to turn down drug makers’ dollars.
But now some doctors and physician organizations say the push to police financial relationships with industry has gone too far.
AMA CEJA: Senator Kohl Exerts Pressure for Further Restrictions
Policy in Medicine
August 10, 2009
With health care reform stalled at least until September, the focus on medical organizations is gaining momentum. For example, the Wall Street Journal recently focused on the American Medical Association’s (AMA) yearlong goal of drafting a new ethics policy aimed to limit industry influence on continuing education for doctors. As a result, Senator Herb Kohl (D-WI), sent a letter to the AMA for a status report of how the new legislation was progressing.
Although the Committee acknowledged that there “is a role for valid physician-industry relationships,” Senator Kohl still noted the concerns about “real and apparent conflicts of interest associated with these arrangements. Consequently, he asked about the American Medical Association’s Council on Ethical and Judicial Affairs report regarding industry involvement in medical education.
Specifically, he recognized that although CEJA initially addressed in a report, “physicians must not accept industry funding to support professional education activities,” since then that report has been rescinded. The Chairman then asked the AMA to provide a status update as to why this recommendation was removed.
University of Wisconsin to Male Hormone Marketing: Testosterone prescriptions soar despite weak research, risks
Posted: Aug. 8, 2009
By John Fauber of the Journal Sentinel
The Milwaukee Journal Sentinel is at it again attacking the CME program at the University of Wisconsin with stories based on innuendo and without even bothering to interview the University staff for their side of the story.
Read what Policy in Medicine says about the article. It takes a different perspective than the Wisconsin paper.
Accreditation Council for Continuing Medical Education Adds Multimedia Education Resources to Its Web Site
PharmaLive
August 13th, 2009
I am sure all of you know about this but just in case.
Editorial: U should lead on conflicts of interest
Disclosure, leadership needed to police doctors’ ties to industry.
Minneapolis StarTribune
August 15th
Another article spurred by the self proclaimed health care reform architect, Iowa Sen. Chuck Grassley who is pushing for an overhaul in disclosure of physicians’ financial ties to industry
UW linked to ghostwriting
By John Fauber and Meg Kissinger
Milwaukee Journal Sentinel
Posted: Aug. 15, 2009
“As fears were growing about the link between hormone therapy and breast cancer, a drug company paid the University of Wisconsin to sponsor ghostwritten medical education articles that downplayed the risks, records obtained by the Journal Sentinel show.
The five articles were funded by Wyeth, the company that made the top-selling hormone therapy products. The articles, published in 2001, appeared under the names of doctors who specialized in diseases common to menopausal women, but actually were written by professional writers paid by the company.”
Our public face. Geeeez.
Add comment August 17, 2009
