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Fraud, Funding, and the First Amendment:
How did CME get caught up in Washington Health Care Debates?

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INTRODUCTION

By Judith K. Ribble, Ph.D.

How did CME get caught up in Washington health care debates? This question couldn't be more timely this month, due to some letters sent several weeks ago to a group of pharmaceutical companies by the two senior members of the powerful Finance Committee, Senators Grassley and Baucus.

The committee is concerned that companies may be awarding educational grants to groups that could be influenced to promote off-label uses of regulated products - that is, new uses of drugs that have been approved by the FDA for other uses. The committee is also looking into the possibility that financial grants may be compromising the independence of groups that publish practice guidelines.

For many years, CME was a quiet backwater in the educational landscape of medical schools, specialty societies, and state medical associations. CME has traditionally been positioned as a self-regulating industry lying outside of federal scrutiny.

ACCME accreditation is voluntary;
CME is an honor system, relying on the physicians' unquestioned integrity in reporting "credit hours";
Faculty, authors, and learners were peers, with the ethical responsibility to hold the good of their patients as their highest priority;
Pharma reps handed out reference books, stethoscopes, and football tickets with impunity - and brought pizza to noontime grand rounds.

But that was way back then, and now a sea change has come over the CME enterprise. Perhaps the most important factor in the genesis of this change is that CME has now attracted the attention of the federal government, which is spotlighting CME and questioning the right of physicians to discuss off-label uses within the CME environment. This turn of events has been a rallying call for persons [like John Kamp] who are dedicated to preserving the free speech privileges set down in the First Amemdment to the Constitution of the United States: namely, "Congress shall make no law … abridging the freedom of speech…." It is a great honor to introduce John Kamp, Executive Director of the Coalition for Healthcare Communication in New York City. John

Earned a law degree from the University of Tulsa College of Law
Earned a Ph.D. from the School of Journalism, University of Iowa; [which explains why he was a reporter and editor of a military newspaper during the Vietnam war;
Was admitted to the District of Columbia bar;
Has served in advisory roles with
The Federal Trade Commission
The Food and Drug Administration;
The US Dept of Commerce,
John is a member of the AMA's collaboration task force, and sits on the advisory board of the newly formed National Commission for Certification of CME Professionals.

Let's see what John can tell us about "Fraud, Funding, and the First Amendment - - and how all three are of concern to healthcare policy-makers … and to the CME community.

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