A recent commentary in the Huffington Post discussed when a patient should “Trust their doctor” and when to get a “second opinion.” While the article offered some insight for patients about when to get a second opinion, the author clearly misstated one of his comments about medical education.
The author, Jacob Teitelbaum, M.D., a board certified internist and Medical Director of the Fibromyalgia and Fatigue Centers, discussed how patients should address what to do when there are two to three best treatment options and how to best determine what the benefits, risks, and cost of each are. Dr. Teitelbaum however, noted that this decision can be difficult for patients because “medicine is a business and economic factors often cloud a practitioner's judgment.” He noted that, “financial incentives are involved and patients need try to understand their potential influence on the doctors.”
Specifically, he tried to assert that, “virtually all of most physicians' ongoing medical education is paid for by the drug companies and represents slick advertising masquerading as educational activities.” Such an assertion is clearly erroneous. In making such a claim, Dr. Teitelbaum clearly ignored recent data from the Accreditation Council for Continuing Medical Education (ACCME), which showed that industry support of continuing medical education (CME) has been significantly reduced over the past several years, and now makes up less than half of all CME funding. In fact, since 2007, commercial support has declined $355 million or 29.3%. Moreover, the total percent of commercial support as part of the overall CME budget dropped from 47.5% (2007) to 39.0% in 2009. Fewer companies are funding CME programs as well. Therefore, Dr. Teitelbaum’s claim that doctors get “all” of their CME paid for by drug companies is clearly wrong, since well over half is not funded by industry presently.
Mischaracterizations of industry supported CME and the CME industry are inappropriate, and Dr. Teitelbaum should make a correction to his article to acknowledge the data above. Moreover, his commentary completely ignores ACCME guidelines and Standards for Commercial Support, which ensure that industry supported CME is offered without bias, and at the highest level of integrity. He also ignores three recent studies from last year, which produced substantial data that demonstrate a lack of commercial bias in industry-sponsored CME (Cleveland Clinic; Medscape, and UCSF). Moreover, we know of no evidence to date showing that commercially supported CME has harmed any patients.
In addition, his commentary also fails to recognize a recent survey of over 500 AMA physicians, which showed that physicians have a high regard for industry, especially CME. Specifically, the survey found that 89% of physicians valued industry providing grants to sponsor CME. Moreover, about 9 in 10 attendees say information provided at educational programs is up-to-date and timely, useful, and reliable; more than half of attendees say they often gain knowledge or skills helpful in their practice; and those who practice in rural areas (86%) are especially likely to attend. Additionally, 94% said industry supported CME was very useful or somewhat useful to stay informed about medications to treat particular conditions.
While Dr. Teitelbaum may have the patient’s best interest in mind, his commentary does not offer a balanced perspective from which a patient could adequately evaluate the information he has provided. His clear bias against industry and skepticism towards commercial support of CME are unfounded and not supported by any clear evidence.
Ultimately, patients should talk with their doctors about the kind of CME they receive and physicians should be transparent about their work with industry. This will help patients realize that physician-industry collaboration improves patient outcomes, and has led to increased lifespan for Americans and decreased death rates for cancer and heart disease. Commercially supported CME has led to many of these advances by keeping doctors up to date on breakthroughs, new treatments and clinical data, and updated guidelines for diagnosis and treatment. As such, this commentary should have addressed these important roles that industry supported CME provide to patients and physicians, instead of trying to portray them in a biased light.