Dear Editor: In my view, your writing in “The Positive Side of Cognitive Dissonance” March/April 2005 issue, that “it is unacceptable to use certified education as a marketing tool” was shortsighted.
Since the majority of my career was in marketing up until 1992, when I was given a position that oversaw most of my employer's CME activity, I had a different reaction than you “at my first continuing medical education professionals' meeting.” For me it was the 1994 American Medical Association CME Provider/Industry Collaboration Conference. The keynotewas Robert Ingram, president and CEO of Glaxo U.S., who had provided about $60 million in support of CME in the previous 12 months.
Bob declared: “An accredited, accurate, high-quality, substantive health education program offers us great value for our investment. I have challenged my colleagues at Glaxo to look very hard at our expenses for … traditional marketing: advertising in journals, promotion via direct mail, and … samples.” He said he had urged his company to “reduce — if not eliminate — those expenses” and redirect the funds toward certified CME. He made this statement because he felt passionately about meeting pharmaceutical companies' basic ethical obligation to be the most knowledgeable about their new products and to convey that information to their customers.
Surveys have shown that physicians prefer to gain new product information from CME activity. Moreover, as reported in “Ask the Audience,”March/April 2004: “Even when physicians perceive commercial bias in a certified CME activity, the majority of them still consider the content valid and credible.” Frankly, I was delighted to think that perhaps those physicians understand that the pharmaceutical industry's commercial bias must be consistent with medicine's bias: It's based on patients' improved health!
“The Merriam-Webster Online Dictionary” defines marketing as “an aggregate of functions involved in moving goods from producer to consumer.” Because the public expects their physicians to continue their medical education throughout their careers, and because physicians and state medical licensing boards demand learning about new medications through CME, I would argue that it's OK for certified education to be viewed as a “marketing tool.” Unlike Bob Ingram, my colleagues have the additional alternative marketing tools of online promotion, CD-ROMs, and direct-to-consumer advertising. Please help me explain that those are not as valuable to the public interest as their continued support of CME provider/industry collaboration.
Frederic S. Wilson, BS
Category Manager CME
Procter & Gamble Pharmaceuticals
New Credit Metric
Dear Editor: Thanks for your column “AMA/PRA Performance Improvement Credits,” by Steven M. Passin and Susan O'Brien [March/April 2005]. You (and Medical Meetings' readers) should be aware that American Academy of Family Physicians prescribed credit is also now available for these activities using the same criteria as AMA PRA. In addition to the good information you shared regarding the criteria for performance improvement activities, I appreciate your calling attention to the move away from a time-based credit metric. AMA PRA and AAFP staff have worked very hard over the past couple of years to have parallel systems for new CME formats, including point-of-care learning and performance improvement in practice. Thanks for helping us spread the word to CME providers.
Nancy L. Davis, PhD
Director, Division of CME
American Academy of Family Physicians
Tsunamis and Terrorism
Dear Editor: Great opinion article, “Tsunamis and Terrorism,” by Sue Pelletier, in the January/February 2005 issue. I live in New York City, have survived both World Trade Center blasts, and fear terrorism on a daily basis. Having been in Israel from 1990 to 1991, a part of which time was during the Gulf War, I experienced first-hand Israeli doctors' response to terrorism and disaster on a micro level (bus bombings, as this was a year or two before suicides bombings were initiated) and macro level (Katayusha rockets). As you suggest, this behavior is learned, and sadly Israeli doctors had the need to develop this expertise a long time ago.
Unfortunately, the U.S. government is decades behind Israel in setting up the proper infrastructure to facilitate emergency responses, and it is slow in developing, communicating, and training the states about these plans, even in this nuclear and Internet era, where we lack the luxury of time. It is therefore critical for the medical and scientific community to stay ahead of our government in preparing our country for medical disasters. We should be blessed with decades of peace before we would need to implement our preparedness, but continued upfront investment in the development and dissemination of programs like that of Clements' and Evans', mentioned in the article, is critical.
Rona C. Rubin
Directory, Allergy & Respiratory, Product Evaluation Group
Pfizer Global Pharmaceuticals
New York City