… of the Senate hearing on Continuing Medical Education. It should be starting about now…
Oh. Here it is!
Senator Kohl, specs low on nose, summarizes the problem — “Crux of today’s hearing… Do they instead market the industry’s latest products? Greater transparency, stronger firewalls, need to be considered… I’m disappointed that the AMA has not yet updated their ethical guidelines on this… “
Martinez: “Accounts of ethical lapses on the part of some doctors and pharmaceutical companies are troubling… Sometimes the line between promotion and education can be blurred… ”
Franken: “How are patients affected by COI? … Unlimited and far from impartial interactions between industry and providers… This often has a negative influence on outcomes… Drives up prices to patients… Medical schools are over-reliant on industry funds… CME is another example of the same thing… ”
HHS/Inspector General guy: A little stiff, nervous. “An honest tale speaks best being plainly told – Shakespeare.” As opposed to glitzy biased CME tales. Wants full prohibition of industry support of CME. Wants firewalls – money yes, but independent grant organizations to disperse the money. Or doctors can pay for their own education. This might make for higher quality if they’re doing the paying. Growing concern about the quality of CME — shift cost to physicians.
Steven Nissen: “CME has grown into an enormous industry with extraordinary influence on the practice of medicine… CME has become an insidious vehicle for the aggressive promotion of drugs and devices. This now dominates the education of physicians. Marketing cleverly disguised as education…. With a wink and a nod the communication company selects speakers they know will please the industry. I can almost always guess who the speakers will be… Who is guarding the integrity of the process? I’ve written to the CME certifying agency with many complaints about bias – my letters were never even acknowledged.”
Next speaker: “It is impossible to find any aspect of medicine in which industry does not have significant control… Industry funding creates bias… Need to be free of industry influence… Stronger measures are required… Current situation unacceptable.”
Jack Rusley, med student, AMSA: He’s wearing his white doctor suit! “Medical research must serve the public and not physician lifestyles… Why do students care so much about these issues? … Not yet tinged with the streak of cynicism… My computer’s shutting down… Sorry… I’ll continue speaking off the cuff… Med students used to be docile in regard to authority… Not anymore… After pressure from Senator Grassley, the press, and students, Harvard has reviewed its COI policy and now has a passing grade on the AMSA scorecard.”
Question session. Martinez, a lawyer, is shocked because continuing ed in the law is not sponsored by any industry. No money involved.
The bias was so terrible at a recent CME session Nissen wandered into that “I had to walk out.”
Another speaker: “Physicians are accruing the education capital here — They should pay for it themselves.”
Franken asks about the accreditation organization for CME. Nissen: “I can assure you that a considerable amount of CME … is marketing. It is not restricted in any way. It is highly biased. We therefore need a new system of certification. We need this organization to go away altogether. There’s no will to police this.”
[I’m sure I’m getting some names wrong, etc. Will correct later. This is live-blogging.]
Franken: “Is there anything good to say about CME, besides better hotels and shrimp?”
Nissen: “There are a few good CMEs. But most are subtly or not so subtly organized to get people to buy a product.”
Another speaker: “CME hugely drives high costs in health care in this country. We spend ninety billion dollars a year more than we should be spending. This machine for getting doctors to prescribe the most expensive medications is one of the big reasons for the problem…. It drives me crazy to hear all this talk that we can’t afford health care reform! We can. We need to make these changes.”
Enough. The second panel’s here. They’re the pro-COI guys. I’ll let one of their fans live-blog that.