Comments on: How to make industry influence transparent in continuing medical education

By: Sarah G

Sarah G — Mon, 31 Aug 2009 19:07:43 +0000

I could see the usefulness of such a site, especially since it could help identify focal areas of commercial interest and reveal potential areas of abuse. I’m not certain such a site would be possible in the near future, since Congress seems to be having enough trouble deciding where to spend our taxes.

By: Larry Husten

Larry Husten — Mon, 31 Aug 2009 14:57:20 +0000

I don’t think the website should REPLACE current disclosure but serve as an ADDITION to current disclosure requirements.

By: Sarah G

Sarah G — Mon, 31 Aug 2009 14:35:07 +0000

But, in much smaller type at the bottom of the page will be another phrase: “this educational activity is supported by an independent educational grant from” a large pharmaceutical or medical device maker.

This is referred to as ‘disclosure’, which is mandated by the ACCME (Standard 6 in the ACCME Standards for commercial support). ACCME regulations demand that this information be disclosed to the participants, or the provider loses their accreditation. These standards have been revised repeatedly in the past few years because of the corporate influence you’re talking about.

Your proposed web site should probably be renamed HealthCareCE.gov, since most health professionals are required to take CE. The information could then be provided by the ACCME, ACPE, ACEP, AOA, ANCC, AAFP, and other groups offering CE accreditation. None of them are government entities.

I would think, though, that even with smaller type, the physician would be more likely to see the disclosure on the brochure, CE company’s Web registration site, or at the conference than on some government Web site he/she already has no time to visit.

By: Paul MD

Paul MD — Wed, 26 Aug 2009 14:22:04 +0000

I would imagine that the national boards of the docs in the states not requiring cme’s will still want them to maintain board certification. How is that handled and has there been any adverse outcomes trends in these states since implemented? I would imagine almost to a certainty that there have been no negative impact with the suspension of the requirements.

By: Editorial: Prescription for medical education: sunshine « CardioBrief

Editorial: Prescription for medical education: sunshine « CardioBrief — Wed, 26 Aug 2009 03:14:07 +0000

[...] to readers: The following editorial by CardioBrief’s Larry Husten appears simultaneously in a slightly different form on KevinMD.Com. CardioBrief thanks Dr. Kevin Pho for the opportunity to bring this piece before a much wider [...]

By: twaw

twaw — Wed, 26 Aug 2009 03:02:05 +0000

Just for S&G’s, does anyone, anywhere, have evidence (remember evidenced based medicine?) that CME requirements do anything to improve clinical outcomes, reduce malpractice, or otherwise do anything positive for the delivery of health care in America? If not, then the whole shebang should be discontinued, and the rest of the country should follow New York, Vermont, and Colorado in abandoning CME requirements. Then, we don’t have to worry about transparency, corporate influence, or any other perceived conflicts of interest.

By: Larry Husten

Larry Husten — Wed, 26 Aug 2009 02:47:27 +0000

Alec: I feel more confident in my proposal if the best argument against it is that no one is really interested in transparency. Clearly a great many people are interested in it, as the demands for increased transparency have been building in so many areas of life. Of course, cockroaches always run from the light. What are you afraid of?
I see no inherent reason why CME.gov needs to be particularly expensive to run or require much annoying paperwork.

Nuclear fire: I completely support your idea for a similar website for lobbyists! I see no reason why the two ideas should be mutually exclusive. In fact, they are part of the same broad movement for greater transparency mentioned above.

By: Nuclear Fire

Nuclear Fire — Wed, 26 Aug 2009 02:24:36 +0000

I’m a little skeptical about the utility of such a proposal. I’d be a bit more interested in seeing a similar website for lobbyists and our congressmen.

By: alex

alex — Wed, 26 Aug 2009 01:58:47 +0000

Transparency for who? What is this massively expensive ordeal of having to document every single dollar, participant, material and session actually for? Who do you envision going to this website and why? It brings “transparency” to who paid for your local general surgeon’s CME. But it’s a pretty safe bet that nobody in your community cares in the slightest whether it was US Surgical or Covidien.

This sounds like a large amount of annoying paperwork for a web site nobody will ever go to. Thus I fully expect the government to jump all over it and mandate it within a year.

By: Larry Husten

Larry Husten — Wed, 26 Aug 2009 00:41:43 +0000

I don’t think you’ve really responded to the point of the article. Although I am no fan of industry support of continuing medical education, my article does not propose banning or even limiting commercial support for CME. Instead it proposes that all industry support be fully disclosed on a public website. So this particular debate is really about transparency. I would be curious to learn your thoughts about this idea, and not other ideas proposed elsewhere. Let’s stick to the subject.