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Recent Articles
Historical Overview of CME
The Journal of the American Medical Association has an enlightening historical overview of the interactions between the drug industry and physicians' continuing medical education.
Critics of the role of pharmaceutical promotion in medical education have claimed that policy changes in the 1980s altered relations between the medical profession and the pharmaceutical industry. However, in the late 1950s and early 1960s, divisions over the role of pharmaceutical marketing in physician education had already surfaced in the medical literature and in Congress. On closer analysis, the history of industry involvement in medical education involved tensions between promotion and education dating back to the origins of the wonder drugs, from antibiotics to antipsychotics.
The authors, Scott Podolsky and Jeremy Greene, who are associated with the Center for the History of Medicine at Harvard, concluded with comments from an advertising executive, spoken in 1963, and then a comment of their own:
As advertising executive Pierre Garai noted in 1963: "The drug business is today, and will be tomorrow, what the doctors cause it to be. Drug advertising too." Any responsible analysis of the role of pharmaceutical promotion in CME must account for the process by which individual physicians, organized medicine, and the regulatory state allowed and even encouraged this process to take place.
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Comments
It's perfectly obvious that pharma companies exert their baleful marketing influence on CME because physicians and their societies prefer it that way. All professions maintain some sort of continuing professional education requirement; that's part of what defines a profession. But lawyers, accounts, and most of the others have to pay for this continuing education themselves. I really can't think of a profession that outsources this responsibility and shirks the expense the way medicine does. The specialty societies could put a stop to pharma-run CME in an instant, but these societies are actually guilds. Their principal concerns lie in advancing the economic well being of their members. Don't expect them to take this perk away from their fellows who demand it as a matter of entitlement.
At a CME conference in February 2007, on lung cancer given by an MD Anderson oncologist, he had a slide which showed how formerly there were very few choices with regard to treatment, but now there is a wide array of (incredibly expensive) treatments. He came right out and said that in his experience, the decision on which treatment to administer was usually made with an eye toward how much reimbursement the prescribing oncologist received for the different regimens. There was an undercover rumbling of discontent among the many private practice oncologists in attendance, which was very evident, and the speaker moved away from the topic immediately after bringing it up.
CMEs is sort of a closed shop. Our non profit tried last year to get educataional credits made available for those professionals who came to our patient/advocacy-oriented meeting on complementary and alternative cancer therapies.
We had difficulties due to being quoted immense costs. Yet attendees really would have learned about ideas they rarely have access to at conventional meetings.
Ann F.
President
The Annie Appleseed Project
www.annieappleseedproject.org