Stiffer CME rules could close speakers' bureaus

Proposed changes in ACCME standards also could impinge on First Amendment rights to free speech, critics say.

By Myrle Croasdale, AMNews staff. March 3, 2003.

The Accreditation Council for Continuing Medical Education is revising its guidelines on commercial support, much to the consternation of CME providers.

The draft CME guidelines have even raised the ire of a legal watchdog group, which says they violate First Amendment rights to free speech.

"It did catch everybody's attention," said Marcia Jackson, president of the Alliance for Continuing Medical Education, of the proposed CME standards.

What's put CME companies on edge is what they see as a tougher stance on conflict of interest as it applies to CME faculty. Drug company speakers' bureaus are a popular resource for CME speakers, and the draft has left providers unsure whether they'll be able to use physicians on these rosters.

A paraphrase of the guideline many are questioning reads: A person with a true conflict of interest will be excluded from being a teacher, author or joint sponsor. Examples are a person who receives funds from a commercial interest to teach on the same content. This allows for the continuation of speakers' bureaus, but will exclude those persons whose relationships constitute an actual conflict of interest.

CME providers question whether it will be enough to disclose a speaker's connection to a commercial firm or if such physicians will be ineligible to teach CME.

"At what point does one say this individual has a conflict of interest to the degree that they'd likely be biased?" Jackson said of providers' concerns.