TELL-ALL DISCLOSURE RULES PROPOSED

CME directors who have a hard time getting faculty to disclose their financial relations with industry (a top issue of concern at the Alliance for CME conference) may get some help — or at least moral support — from a set of guidelines proposed by eight of the nation's top NIH-funded medical schools and six nationally prominent leaders in academic medicine.

The group's recommendations — submitted in February to the Association of American Medical Colleges — address inconsistencies and gaps in policies described in a series of four articles that appeared last November in the Journal of the American Medical Association and The New England Journal of Medicine. The journal articles showed that nearly all institutions have established policies for monitoring potential conflicts but that there is currently considerable variation in the way medical schools and teaching hospitals manage conflicts. Many rely on a case-by-case method with few clearly delineated guidelines. Among the recommended actions:

• Require disclosure of financial interests to the institutional review boards that approve clinical research trials.

• Apply policies concerning required disclosure of financial ties to anyone involved in research — faculty, students, and staff. Disclosure should be both on a set periodic basis as well as in real time if their situation changes.

• Define financial interests that should be disclosed to include any fees, honoraria, or gifts associated with consulting or lectures, equity including stock options, and payments for directorships or executive roles.

Presumably, in such an atmosphere, faculty disclosures regarding participation in scientific talks at CME events would become easier to manage and enforce. But not all providers agree that the Accreditation Council for CME's Standards for Commercial Support disclosure guidelines need bolstering.

Floyd Pennington, PhD, director, Institute for Physician Professional Development, University of Florida School of Medicine, and also a member of the Alliance for CME's Medical Schools Special Interest Group, says, “I think what we have now, properly administered, is all we need. He also fears that stricter enforcement of disclosure rules will push CME providers back into the “CME cop” role, which he thinks is not only a bad idea in terms of relationships with speakers, but is also not the best use of the CME provider's efforts. “We don't need clout on disclosure,” he says. “We need clout as facilitators of improved physician performance. That's much harder to do than beat faculty over the head about disclosure.”