The Association of American Medical Colleges Task Force on Industry Funding of Medical Education has issued a report recommending that academic medical centers strengthen their policies regarding relationships with pharmaceutical, medical device, and other health industries in order to ensure an "effective and principled partnership."
The 39-member task force, which was chaired by the former CEO of Merck and included representatives from the pharmaceutical industry and academic medical centers, worked for two years on the report. Of particular interest to continuing medical education and healthcare meeting professionals are the recommendations concerning gifts and education.
Management of commercial support should be handled by one centralized CME office within AMCs, says the report. In addition, CME offices should develop audit mechanisms to ensure that their activities are in compliance with the Accreditation Council for CME Standards for Commercial Support. The task force also recommends that the AAMC collaborate with theto create an external process for monitoring CME activities, a move that could address the concern expressed in the Senate Finance Committee's April 2007 CME report, which noted the lack of such auditing as a weakness in the ACCME's oversight system.
AMCs should prohibit physicians and other, staff, students, and trainees from accepting any gifts from industry, whether those gifts are offered on-site or off-site. Even gifts that are practice-related can create conflicts for physicians and erode their professionalism, the report states. The suggested guidelines would be stricter than the American Medical Association's Ethical Opinion on Gifts to Physicians, which says that gifts of minimal value that benefit patient care or are practice-related are acceptable.
Aiming to draw a clear separation between industry-sponsored promotional activities and certified CME, the report recommends that academic medical centers should strongly discourage faculty from participating in industry-sponsored speakers bureaus. (In a letter attached to the report, task force representatives from Pfizer and Eli Lilly & Co. stated that they disagreed with this suggestion.) If faculty do participate, the AMCs should mandate that they disclose the relationship and accept only payments that are fair market value, the report says.
Implementing such policies would require major behavioral and cultural shifts. The report details the "hidden curriculum” in academic medical centers, which teaches students that they deserve gifts and perks from industry. To change those deeply entrenched attitudes, the report recommends that AMCs design educational programs to teach students and faculty how gifts can bias their decision-making process.
One aspect of industry/CME relationships the report does not recommend curtailing is commercial support. Although funded by a grant from the Josiah Macy Jr. Foundation, interestingly, the AAMC task force did not come to the same conclusions as the Macy Foundation's report, issued in January, which asserted that all commercial support should be phased out over a five-year period.
For the full 43-page report, visit www.aamc.org.
What do you think about the AAMC report? Send your comments to Tamar Hosansky.
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