Recently William Heisel, Senior Communications Officer at the Institute for Health Metrics and Evaluation, interviewed me about the CME industry and the roll of medical education companies. The questions he asked along with my answers were published on his blog under the title: Antidote: New Ways to Investigate Untold Health Stories. There are two parts to the interview.
A key issue that we discussed was how bio-medical education companies insure that their passion is truly put to educational use and not channeled into a much bigger marketing effort. I noted that education companies are not influenced by the ‘big marketing’ efforts because we go out and apply for grants from a variety of sources including government, foundations, and industry.
On another key point, I acknowledged that one of the reasons pharmaceutical and device companies pay for the education portion of CME classes is because it's part of their public health mission. In fact, by offering grants for courses, these companies are trying to make sure that doctors are as up to date as possible. It's the translation of science to medicine. It's taking what's available in science and translating it into the clinical practice.
Regarding bias, I also outlined to Mr. Heisel that that medical education companies resolve bias as a part of their business practices to remain accredited. Most companies have all their information reviewed by an outside independent physician with no ties to industry to look to see if there is any bias.
Medical education companies also use a very strong vetting with their faculty to make sure that if they have a conflict, there is someone else reviewing their content. Some companies even send potential faculty a disclosure form before they are even engaged. Another way medical education companies eliminate bias is by disclosing information before presentations and disclosing information in the handout materials for the live meetings and on the Web.
During the second part of the interview, we took on the issue of how ghostwriting and conflicts of interest are two separate and unrelated issues. Whereas ghostwriting is publishing a paper and using the company to write it, CME does not do that. Rather the doctors who work for medical education companies have no direct contact with those that fund the programs, and most of the time they do not even know what company is funding the work. The doctors who teach CME courses are there to present good science.
The discussion then focused again on media coverage regarding industry-funded CME. I noted that most coverage has not been fair because journalists do not realize that there is no scheming behind the scenes with drug companies. Instead, CME is very straightforward. Companies choose to educate doctors about a particular topic, and then they apply to grants from foundations, the government and companies to pay for it. While certain companies have been put in the hot seat recently, these cases should not overshadow the convergence of science and industry that has benefited millions of patients and their physicians. I also acknowledged that certified CME companies do not have back and forth drafts with drug companies before a program is held. That is the business of promotional education which is FDA regulated and not accredited.
At the end of the interview I noted that although health care reform is bringing about an uncertain time, doctors are always going to need education, and so there always will be a role for medical education companies. As a result, talking about the issues facing CME and bringing to light the changes that need to be made regarding the perception of bias and industry funding are important first steps to ensure the future of medical education.