Stephen Lewis, MA, CCMEP

Using the logic of the American Medical Association’s Council on Ethical and Judicial Affairs, we should not support recent recommendations on cholesterol screening approved by federal government health experts and the American Academy of Pediatrics.

In fact, the 2011 conflict-of-interest opinion approved by AMA’s CEJA runs counter to almost every recent healthcare guideline adopted by the field of medicine. It seems that AMA confuses the “potential” for conflict with “actual” conflict.   
This kind of thinking is bad for patients. Let me explain.
The potential for conflict abounds in medicine. Take the recent cholesterol screening recommendation. The government’s National Heart, Lung, and Blood Institute supported cholesterol screening for children between the ages of 9 and 11. This screening for patients earlier in life was supported by the American Academy of Pediatrics.

The recommendation clearly had the potential for conflict of interest. The Academy was supporting a guideline that
would bring additional business to its members. More screening at an earlier age equals more financial gain for
pediatricians.

But the potential for conflict was ameliorated by the evidence. Diet changes, obesity rates, and good science caused experts to support screening at a lower age. When evidence nullifies a potential conflict, medicine typically rallies behind the facts. Not so for AMA’s CEJA.

The 2011 CEJA opinion dismisses significant evidence regarding the absence of bias in CME, despite potential conflicts of industry grant funding for CME.

A new AMA CEJA webinar continues to cry wolf about potential conflicts of industry grant support, citing the opinion that “when possible, CME should be provided without such [grant] support.” When asked about this statement, an AMA staff member replied that this “expresses the aspiration of this ethical opinion.”

Let’s get this straight. Just like the cholesterol screening recommendation, a potential for conflict exists with CME grant funding from industry. And just like the screening issue, the potential for conflict in CME was addressed by evidence and sound science, not to mention existing CME rules.
But despite these facts, the AMA still holds on to an “aspiration” that isn’t supported by evidence? Instead of relying on the same logic and good science that guides the American Academy of Pediatrics and many other specialty societies, AMA’s CEJA chooses to chase shadows rather than follow the facts.

 If CEJA used this same logic to predict the weather, they would issue a daily warning for the “potential” for tornadoes. Let’s give a hand to AMA CEJA and weather forecasters, the only two groups who can consistently be wrong and still keep their jobs.  

Stephen M. Lewis, MA, CCMEP, is president of Littleton, Colorado–based Global Education Group. He can be reached at slewis@globaleducationgroup.com.

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