Continuing Medical Education Community Critiques Proposed New Rules

“As CME providers, we should be able to use the best and the brightest to develop educational content. If we are to disqualify these physicians based on “perceptions” of conflicts of interest, we fail to provide the highest quality CME to physicians while impugning the integrity and honesty of many of the finest physicians and educators in the world.

“Based on this draft document, accredited providers would be required to be the “Conflict of Interest Police,” making judgments on the possible commercial bias of a proposed faculty member before a word of the content has been written. Where are the data to support such a significant change in policy?”

The above paragraphs, excerpts from the North American Association of Medical Education and Communication Companies’ (NAAMECC) response to the draft revision of the Standards for Commercial Support, express the views of many in the CME industry that the Accreditation Council for CME has gone too far in attempting to curtail bias in CME activities. The Standards for Commercial Support regulate relationships between continuing medical education providers, such as specialty societies, hospitals, and academic medical centers, and funders of CME, such as pharmaceutical companies.

But some providers say it’s time for the rules to change. “The draft Standards for Commercial Support are just the most recent step in a larger movement in the world of medicine,” says R. Van Harrison, PhD, CME director, University of Michigan School of Medicine, Ann Arbor. While CME is important, when it comes to conflict of interest and potential bias, the first lines of fire in terms of public interest are in research and publications, he says. And while ACCME is just beginning to tackle what is acceptable in terms of conflict of interest, its parent organizations already have taken a stand on it in those areas.

“The ACCME is just catching up with changes that are already happening elsewhere in medicine,” he says. “For those who say the existing disclosure rules don’t need to change, well, they’re out of date with what’s already happened in the bigger picture. With commercial sources funding more than 50 percent of the out-of-pocket financial expenditures of the 674 nationally accredited CME providers, we are required to react, just as those in research and publications have been. If CME does not recognize that larger world change, we will be scorned and marginalized.” For more commentary on the Draft Standards for Commercial Support, watch for the June issue of Medical Meetings.

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