a start…

Posted on Thursday 23 June 2011

AMA Votes to Discourage Commercial Support of CME
The Carlat Psychiatry Blog

by Danny Carlat
June 21, 2011

Something huge happened yesterday at the American Medical Association House of Delegates meeting in Chicago. Although the meaning of what happened will be spun throughout the blogosphere, twittersphere, and schmuckosphere, the bottom line is that the AMA just voted most commercial funding of CME out of existence. Specifically, the delegates voted to approve a report of the AMA ethics committee that calls for a near elimination of industry support for CME. The report is entitled "Financial Relationships with Industry in Continuing Medical Education," and can be read in its entirely here.
It’s actually a fairly clear report worth taking the time to read. Here are the recommendations:
The Council on Ethical and Judicial Affairs recommends that the following be adopted and the remainder of this report be filed:
    In an environment of rapidly changing information and emerging technology, physicians must maintain the knowledge, skills, and values central to a healing profession. They must protect the independence and commitment to fidelity and service that define the medical profession.

    Financial or in-kind support from pharmaceutical, biotechnology or medical device companies that have a direct interest in physicians’ recommendations creates conditions in which external interests could influence the availability and/or content of continuing medical education (CME). Financial relationships between such sources and individual physicians who organize CME, teach in CME, or have other roles in continuing professional education can carry similar potential to influence CME in undesired ways.

    CME that is independent of funding or in-kind support from sources that have financial interests in physicians’ recommendations promotes confidence in the independence and integrity of professional education, as does CME in which organizers, teachers, and others involved in educating physicians do not have financial relationships with industry that could influence their participation. When possible, CME should be provided without such support or the participation of individuals who have financial interests in the educational subject matter.

    In some circumstances, support from industry or participation by individuals who have financial interests in the subject matter may be needed to enable access to appropriate, high quality CME. In these circumstances, physician-learners should be confident that that vigorous efforts will be made to maintain the independence and integrity of educational activities.

    (a) be transparent about financial relationships that could potentially influence educational activities.
    (b) provide the information physician-learners need to make critical judgments about an educational activity, including:
      (i) the source(s) and nature of commercial support for the activity; and/or
      (ii) the source(s) and nature of any individual financial relationships with industry related to the subject matter of the activity; and
      (iii) what steps have been taken to mitigate the potential influence of financial relationships.
    (c) protect the independence of educational activities by:
      (i) ensuring independent, prospective assessment of educational needs and priorities;
      (ii) adhering to a transparent process for prospectively determining when industry support is needed;
      (iii) giving preference in selecting faculty or content developers to similarly qualified experts who do not have financial interests in the educational subject matter;
      (iv) ensuring a transparent process for making decisions about participation by physicians who may have a financial interest in the educational subject matter;
      (v) permitting individuals who have a substantial financial interest in the educational subject matter to participate in CME only when their participation is central to the success of the educational activity; the activity meets a demonstrated need in the professional community; and the source, nature, and magnitude of the individual’s specific financial interest is disclosed; and
      (vi) taking steps to mitigate potential influence commensurate with the nature of the financial interest(s) at issue, such as prospective peer review.
May it be a serious undertaking. At least having this on the books is a start…

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