Commercial CME funding and the rise of medical errors

While the percentage of commercial support for continuing medical education (CME) has continued to drastically drop over the past few years (29% decrease from 2007 to 2009), recent data, which show an epidemic of medication errors in hospitals, make this decrease even more troublesome.

At a time when 30 million more patients will flood our hospitals, do we really need to reduce the amount of funding that goes to educate our doctors and health care providers? With an increase of 277% in medication errors this past year, according to a recent two-year investigation of Nevada hospitals by the Las Vegas Sun, doesn’t it seem obvious that the more resources we take away from educating our physicians about the proper use of medications, the less they will have to learn about how to treat us? The evidence speaks for itself already, unfortunately.

What is more disturbing about this data is that “Nevada hospitals aren’t unusual.” In fact, “there’s evidence that facilities across the country continue to hide their safety lapses.” Critics of commercial support are content on banning such funding to save costs and money. But how can that be possible if physicians who are not kept up to date on treatments “inflict unnecessary pain and suffering on patients, while also driving up the cost of healthcare, which harms other patients by limiting their access to care?”

What made the Nevada hospitals a specific target was that hospital billing records for 2.9 million inpatient visits that have been submitted to the state over the past decade showed 1,363 occurrences, in which patients are harmed or threatened with harm, but Nevada hospitals reported only 402 events for those years.

“In other words, there was a big discrepancy between what the hospitals reported to the state and what their billing records revealed about medical errors they actually treated.” The article also lists specific occurrences and uses a table to show the types of events reported.

As a result of this data, “the state now plans to audit hospital medical records in order to find out what’s really going on.” This practice could also spread because “many other states collect hospital billing records, just as Nevada does.” If similar evidence is found of errors in hospitals, it will make a strong argument for physicians needing more education to reduce such problems and with less commercial support for CME, finding resources to provide such programs will be difficult.

A few years ago, the Joint Commission, which accredits hospitals, began requiring them to report “unexpected outcomes” — another term for sentinel events. A hospital survey done soon afterward revealed that a majority of hospitals disclosed medical errors at least some of the time. Through the Joint Commission’s database, evidence showed that the number of sentinel events that all accredited U.S. hospitals had reported in 2008 and 2009 for certain kinds were continuing to increase: e.g., 126 wrong-site surgeries were reported in the first nine months of 2009, up 34 percent from the same period a year earlier. Medication errors nearly tripled from 2008 to 2009.

Data such as this reveal a need for more education of health care providers and hospitals to prevent and detect such errors. If commercial funding of CME continues to drop at the current pace, who knows how many errors physicians and hospitals will be making.

Accordingly, In light of the fact that many hospitals accept commercial funding for CME, it would be extremely harmful to patients to prohibit such events or for staff to be prohibited from attending these events.

That’s why it would be in the best interest of patients, physicians and staffs at hospitals to have the ability to give continuing education programs supported by industry on medications that will help resolve medication errors and other issues that are obviously becoming an increasingly serious problem. And since hospital funds may be tied up paying out claims for such errors, commercial funding seems to be the best and most appropriate source for effectively reducing these gaps in care.

Thomas Sullivan is founder of Rockpointe who blogs at Policy and Medicine.

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