After completing four rigorous years of medical schools, and up to six more in residency, doctors in 46 states are required to obtain continuing medical education (CME) credits every year in order to keep up with the medical times and retain their licenses to practice. After all, why wouldn't we want our physicians to continue learning about the latest updates in medicine?
Like communism, what sounds good in theory does not always work in practice. CME has unfortunately been an example of that. The issue received increased attention this past month thanks to John Fauber's coverage in the Milwaukee Journal-Sentinel and their four-part series "Risk/Reward"
, on various ways in which how the pharmaceutical industry funds CME in order to promote new or upcoming drugs to doctors.
We have talked about bias in CME before; in fact, it is one of the first issues PharmedOut addressed when we formed in 2006. Around that time, Congress started investigating pharmaceutical companies for using CME for marketing purposes. In response, many companies turned away from CME, spending 32% less on the courses between 2007 and 2010.
But, as Fauber shows, "that funding is again on the rise." Pharma spending on courses today is back to pre-investigation levels and is an almost $3 billion industry. However, due to heightened scrutiny and stricter rules regarding relationships with Pharma, much of the money that used to go to CME offices in academic medical centers and hospitals is now going to medical education companies that technically host the CME courses.
As part of the Physicians Payment Sunshine Act provision of the Affordable Care Act, the Obama administration has sought to require payment disclosure when these third party medical education companies are involved. CMS's Open Payments
currently requires disclosure of indirect payments to physicians through third parties starting in 2017 (unless the 21st Century Cures Act passes, which contains a CME exemption along with many other anti-public health provisions).
PharmedOut supports this disclosure and calls for an end to pharma-funded CME courses. Until then, perhaps every pharma-funded CME invitation, course, and certificate should be prominently labeled "Pharma University"