CME/Industry Relations

I read with interest the article “ACCME Draws the Line” (September/October 2007, page 9). You did a nice job bringing to light some issues that need to be addressed.

I have worked in the pharmaceutical industry for 30-plus years and one thing that to this day still amazes me is this term “firewall.” Within the CME arena the word firewall is a term that should mean there is complete separation between the promotional side of medical education and the CME side of medical education.

We see arrangements all the time where an Agency of Record manages the pharma client's brand, the publications plan, advisory boards, sales rep training, etc., and the sister company, a CME vendor, is allowed to submit detailed CME proposals to the CME team of the same pharma company. Is anyone really naïve enough to think that these two med-ed companies — one promotional, one CME — are not sharing information? Dream on. Even though the work is being handled by two different companies, they report up to the same parent company. Do you really think there isn't cross-communication somewhere within the companies? Hmmm…I have a plot of land in a swamp I want to sell you.

What should we do about this? One solution I suggest is a simple one: Any agency, no matter how big or small, doing promotional work at any level on a brand, including publication planning, should be prohibited, as should any and all of their subsidiary or sister companies, from doing CME work on the same brand, within the same company. PERIOD. No exceptions, no arguments. Eliminate the conflict. Eliminate the temptation. When you do this, there will be no need for people to invent terms that really have no purpose but to make one feel good — like the word: firewall.
Pharmaceutical industry consultant
Name withheld upon request

“How are they funding CME?”

Good editorial [“Shape CME's Future,” September/October 2007, page 6]. You state that “Some providers have already disallowed commercial support.” I would like to see a report from these providers telling us how they are funding CME and what changes they have had to make. Surely, their activity has been reduced? And how have they managed to set priorities?
Robert C. Fore, EdD, FACME
Professor & Associate Dean for Academic Affairs, Designated Institutional Official University of Tennessee College of Medicine, Chattanooga, Tenn.

Editor's note: If you have reduced or eliminated commercial support and would like to share your experiences, e-mail

“Just to let you know”

I just read Ann Lichti's article [Evaluation Commercial Bias” September/October 2007, page 19]. I just wanted to let you know there is an official Accreditation Council for CME definition of commercial bias, in the ACCME glossary at “A personal judgment in favor of a specific proprietary business interest of a commercial interest.”
Debra L. Gist, MPH
CME Consultant
La Mesa, Calif.
Editor's note [add excerpt]

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