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Ahem. Let us remind ourselves…

… before we look at what the University of Michigan medical school has just done, let us remind ourselves of the basic truths about Continuing Medical Education. I quote from Marcia Angell:

… In most states doctors are required to take accredited education courses, called continuing medical education (CME), and drug companies contribute roughly half the support for this education, often indirectly through private investor-owned medical-education companies whose only clients are drug companies. CME is supposed to be free of drug-company influence, but incredibly these private educators have been accredited to provide CME by the American Medical Association’s Accreditation Committee for Continuing Medical Education—a case of the fox not only guarding the chicken coop, but living inside it.

… If drug companies and medical educators were really providing education, doctors and academic institutions would pay them for their services. When you take piano lessons, you pay the teacher, not the other way around. But in this case, industry pays the academic institutions and faculty, and even the doctors who take the courses. The companies are simply buying access to medical school faculty and to doctors in training and practice.

… [T]he pharmaceutical industry has no legitimate role in graduate or post-graduate medical education. That should be the responsibility of the profession. In fact, responsibility for its own education is an essential part of the definition of a learned profession.

Simple enough? Fox, chicken coop; lessons wrong way around…

Hokay. Let’s proceed with the announcement from the University of Michigan, reported by the New York Times.

In the latest effort to break up the often cozy relationship between doctors and the medical industry, the University of Michigan Medical School has become the first to decide that it will no longer take any money from drug and device makers to pay for coursework doctors need to renew their medical licenses.

University officials voted to eliminate commercial financing, beginning next January, for postgraduate medical education, a practice that has come under increasing scrutiny from academics, medical associations, ethicists and lawmakers because of the potential to promote products over patient interests.

… [One] leading medical ethicist asserted that the prohibition did not go far enough. Dr. Bernard Lo, lead author of a 2008 Institute of Medicine report on conflicts of interest, said private doctors and academic physicians who are paid to speak for drug companies should be barred from presenting educational material at accredited conferences. “Mouthpieces for their products,” he called them.

… “Industry wouldn’t be paying billions of dollars to do this stuff if it didn’t benefit them,” [another physician said]…

So Michigan boldly leads the way. As other schools attempt to join UM, expect to hear a lot of chickens squawking.

Margaret Soltan, June 24, 2010 3:10AM
Posted in: conflict of interest

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