Coalition for Healthcare Communication: CME Archives

Oncology: Europe Beating US Hands Down on Innovation and CME - the Dumbing Down of US Oncologists

By mtadmin on July 22, 2010 2:23 PM | No Comments

Thanks to Tom Sullivan's Policy and Medicine blog for this report on Medscape's video about why U.S. restrictions on industry support of CME are hindering progress in vital medical fields.

An interesting video and script from MedScape recently discussed a troubling trend in clinical research regarding gastrointestinal (GI) cancers. According to John L. Marshall, Associate Professor of Medicine at Georgetown University, in Washington, DC, all of the major research in this area over the last five years "has been led by Europeans, performed by Europeans, and usually with European patients."

As the Chief of the Division of Hematology-Oncology and Director of Clinical Research at the Lombardi Comprehensive Cancer Center further noted, that although the work on colorectal, gastric, pancreatic, and hepatocellular cancer has all been outstanding, it's just all been done by European investigators. As a result, "they are really taking the lead in this clinical research world, and being led by a very vibrant group of clinicians and translational researchers.

Continue reading Oncology: Europe Beating US Hands Down on Innovation and CME - the Dumbing Down of US Oncologists.

Nature Biotechnology article outlines the compliance problems created by the "Sunshine" provision in the Healthcare Reform Act

By mtadmin on July 16, 2010 10:51 AM | No Comments

From Tom Sullivan's Policy and Medicine blog, July 16, 2010:
As drug companies "prepare for new draconian provisions for reporting on financial relationships with academia," a recent article in Nature Biotechnology investigated whether such efforts to "increase transparency will prove burdensome to researchers and the industry.

The inquiry stems from "the latest fallout from Senator Charles Grassley's (R-IA) campaign for increased transparency between physician researchers and industry." This campaign has included numerous letters and investigations involving doctors, organizations and associations, agencies (e.g. NIH), medical journals, and drug and device companies.

Read entire article, then come back here to comment.

Per Peter Pitts, University of Michigan's Banning of Commercially Supported CME Could Place an Unnecessary Burden on Taxpayers -- Especially in Light of a Recent Study Showing No Bias in Commercially Supported CME Activities

By mtadmin on July 14, 2010 9:49 AM | No Comments

From Peter Pitts's Drugwonks blog: www.policymed.org

Please don't hold the Mayo
Peter Pitts
One of the more interesting subtexts surrounding King James' move to Miami is the negative economic impact it will have on the economy of Cleveland specifically and the Ohio in general.

A similar subtext (albeit one that has been entirely ignored) is the negative economic impact the State of Michigan will experience following the University of Michigan's recent announcement that it will ban any industry-sponsored CME.

The Fighting Wolverines currently receive about $1,000,000 in such services. And in cash-strapped Michigan that ain't chump change when libraries are being shuttered and teachers are losing their jobs.

And for what larger purpose? The U-M's intent in banning industry funding for CME is "to dispel the risk or appearance of conflict of interest."

It will also result in less CME for the university systems physicians. The school expects the number of CME courses to decline "somewhat" as a result of the new policy.

(According to the ACCME, the university produced 499 separate CME activities last year, reaching more than 130,000 physicians.)

"Somewhat" less CME is not acceptable. Does the university expect the taxpayers of Michigan to make up the difference - so that they can exult in their political correctness?

Since healthcare reform is about lowering costs, how will similar moves by other large public universities (motivated not by public health but by "perceived conflicts") be justified?

Speaking of Cleveland, in the January 2010 issue of Academic Medicine (Acad Med. 2010; 85:80-84.), four researchers from the Cleveland Clinic published a paper entitled, "The Effect of Industry Support on Participants of Bias in Continuing Medical Education."

The purpose of the study: "To obtain prospective evidence of whether industry support of continuing medical education (CME) affects perceptions of commercial bias in CME activities."

The method: "The authors analyzed information from the CME activity database (346 CME activities of numerous types; 95,429 participants in 2007) of a large, multispecialty academic medical center to determine whether a relationship existed among the degree of perceived bias, the type of CME activity, and the presence or absence of commercial support."

The study's conclusion: "This large, prospective analysis found no evidence that commercial support results in perceived bias in CME activities. Bias level seem quite low for all types of CME activities and is not significantly higher when commercial support is present."

The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) have adopted a new policy regarding the disclosure of conflicts of interest.

Here's the key paragraph:

"There is no inherent conflict of interest in the working relationships of physicians with industry and government. Rather, there is a commonality of interest that is healthy, desirable, and beneficial. The collaborative relationship among physicians, government, and industry has resulted in many medical advancements and improved health outcomes."

What a unique perspective -- a "commonality" rather than a "conflict" of interest.

We should all pay attention to our nomenclature. It's not really about "conflict of interest" - it's about (as Secretary Sebelius correctly says) "interest." And having an "interest" is not necessarily a bad thing - as long as you're transparent about it.

When it comes to CME and "interest," we need to weigh interest versus benefit. And, as with drugs and devices, we must consider the "safe use" of industry-sponsored CME.

"The best interest of the patient is the only interest to be considered."
-- William Mayo, MD

ACCME Releases 2009 Annual Report Data - The CME Economy Sees 7.7% Reduction in Total Income

By mtadmin on July 9, 2010 11:27 AM | No Comments

From Tom Sullivan:

The ACCME Released their 2009 Annual Report Data, here are some of the highlights:

· In 2009, accredited providers produced more than 95,000 activities, a 5.8% decrease of activities from 2008, and a 15.9% decrease in activities since 2007. In fact, directly sponsored CME activities decreased over 7% between 2008 and 2009.

· Total CME income also showed a significant decrease of $182 million or 7.7% less between 2008 and 2009, and from 2007 through 2009, total CME income has dropped $354 million or 14%.

· Continuing this trend, the 2009 data showed a precipitous drop in commercial support from 2008 to 2009, with $183 million or 17.7% less. Since 2007, commercial support has declined $355 million or 29.3%.

· As a result of this decrease, the total percent of commercial support as part of the overall CME budget dropped from 47.5% (2007) to 39.0% in 2009.

The link to the artiticle includes charts of trends and distribution.

Massachusetts Code of Conduct: Repeal Passes The State House

As part of the state economic stimulus package, Wednesday night the Massachusetts state house passed a repeal of the Pharmaceutical and Medical Device Code of Conduct referred to as the "gift ban". Amendments to keep the gift ban law in place were defeated.

See Tom's article on Policy and Medicine for charts and more links.

AAMC Sees No Need to Cut Off Contacts with Industry

By mtadmin on July 9, 2010 11:15 AM | No Comments

Proposes a Studied Approach to Identifying and Managing Potential Conflicts

Read more...

The Nadir of ACCME

By mtadmin on June 18, 2010 1:10 PM | No Comments

The following was written by Peter Pitts, blogger at www.drugwonks.com. Comments are encouraged.

Once more into the abyss.

The Accreditation Council for Continuing Medical Education (ACCME), the national body that accredits medical education courses has decided that physicians and researchers who work inside the pharmaceutical industry will not be allowed to make medical education presentations at medical meetings.

That effectively means that America's physicians will not be able to be instructed by many of the best and the brightest.

And this is where nomenclature becomes important. It's not about "conflict of interest" - it's about (as Secretary Sebelius correctly says) "interest." And having an "interest" is not necessarily a bad thing - as long as you're transparent about it. When it comes to "transparency," we need to weigh "interest versus benefit." Just like with drugs and devices, we must consider the "safe use" of transparency.

But transparency is no longer good enough for the ACCME - now they want purity - whatever that means.

When is a conflict not a conflict? The answer, it seems - it when it's convenient to the Brotherhood of the Conflict of Interest Priesthood, the COI Polloi.

Who's pure and who isn't? Here's the answer - nobody is 100% pure. Not even Ivory Soap is 100% pure - and it floats!

In the February 7^th edition of The Lancet, Richard Horton points out that the battle lines being drawn and between clinician, medical research and the pharmaceutical industry are artificial at best -- and dangerous at worst. Dangerous, because all three constituencies are working towards the same goal -- improved patient outcomes.

Horton's main point is that we must dismantle the battlements and embrace of philosophy of "symbiosis not schism." It's what's in the best interest of the patient.

The new dictate by the ACCME is the COI polloi out of control. Consider the comments of healthcare icon and NIH director Francis Collins:

"It is a breathtaking sweep to squash something that is really important to us, the science going on in the private sector."

Big Pharma hires the best. And now America's physicians are being denied their counsel.

Do we really want to build the foundation of 21^st century CME on the second best and the almost brightest?

AMA Rejects CEJA Industry Collaboration Report for 4th Time

By mtadmin on June 18, 2010 9:00 AM | No Comments

"For a fourth time in a row, the American Medical Association House of Delegates (AMA-HOD) has sent the Council on Judicial and Ethical Affairs (CEJA) 1-A-10 report on Financial Relationships with Industry in Continuing Medical Education back for more work to CEJA. Perhaps this time they will get the message.

Despite strong opposition (3-1) from those who spoke at the reference committee, the AMA HOD Reference committee recommended CEJA for passage, but on the floor debate it was apparent that the House of Delegates was not in favor of this report as shown in them sending it back for the 4^th time." -- quoted from Tom Sullivan's Policy and Medicine blog.

Follow this link to read more, then come back here to comment.

ACRE Recommends Rejecting CEJA Report and Recommendations re: CME

By mtadmin on June 8, 2010 8:07 AM | No Comments

Follow this link to read. Come back here to comment.

Roundup of Education and Marketing Issues in Light of Health Reform Passage

By mtadmin on April 27, 2010 5:56 PM | No Comments

Tom Sullivan has created a great summary of healthcare reform's effects on the healthcare communication industry. Click to read.

Comments are welcome and encouraged.

Study: CME Providers Have Suitable Oversight to Ensure Compliance

By mtadmin on April 13, 2010 1:34 PM | No Comments

A study by the Cleveland Clinic's Center for Continuing Education showed that there was no correlation between the perception of bias and the commercial support status of an activity such as continuing medical education.

Comments are welcome here.

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