You get what they pay for: Continuing medical education selections

Some in the CME community are working to move it further from the influence of the drug industry.

By Myrle Croasdale, AMNews staff. June 14, 2004.

Over the years, the federal government and physician and pharmaceutical organizations have set guidelines for governing the relationships between the medical profession and the pharmaceutical industry, in hopes of minimizing conflicts of interest.

But one largely unregulated area remains: how CME curricula are generated.

R. Van Harrison, PhD, director of the Office of Continuing Medical Education at the University of Michigan Medical School, believes it is now time to address conflict in that arena as well.

"CME subjects are distorted and biased toward topics related to medical products with a high financial yield," said Dr. Harrison, who wrote an article on this topic in the Journal of Continuing Education in the Health Professions in September 2003.

"The ACCME [Accreditation Council for Continuing Medical Education] has focused on an old model of commercial bias within a CME activity, asking, 'Is it balanced?' " Dr. Harrison said. "My whole point is that there is another level of bias in the system in what topics are chosen."

Courses on diseases treated with high-profit drugs are taught more frequently, Dr. Harrison said, because CME providers are able to get pharmaceutical funding for them. Speakers are easier to find because they're paid higher fees. More participants attend these courses because the commercial support makes them either less expensive or free to attendees. The sheer number of these courses, in turn, generates a false sense of their importance.