American Psychiatric Association Assembly Votes for Member Autonomy in Determining Conflicts of Interest

This year the American Psychiatric Association (APA) Annual Meeting, in which the organization provides hundreds of scientific sessions, new research poster sessions, prominent guest speakers, and opportunities to network and obtain continuing medical education (CME) credits.  The 2010 meeting was held in New Orleans from May 22 to May 26, 2010, and included 14,000 participants.

Participants this year saw conflict of interest slides before presentations, and their 240-page program book saw fewer commercially supported classes and entertainment, and no gifts or free meals at the 5-day event. 

One of the major accomplishments of the 2010 meeting was that the APA Assembly rejected several proposals (rules) that would have restricted access to important medical information and created a road block between APA members and the pharmaceutical industry.  Previous rules APA has enacted include a ban on industry funded meals and guidelines regarding the use of experts.

The APA Assembly did however adopt a statement that psychiatrists should be aware of their conflicts (of interest) and manage them.  While some believe this may be a “vague” statement, the decision of the APA Assembly reflects the correct approach for doctors to maintain their independence in choosing appropriate CME programs and partnerships with industry.

One of the proposals voted down, was a document that Paul S. Appelbaum, M.D., APA former past-president, worked on as a chair of a workgroup appointed by the APA Board.  Dr. Appelbaum also commented on his experience at this year’s meeting in a blog post on APA’s website.

Despite the dissatisfaction with media about the outcome of APA’s Annual Meeting, it is clear that the organization values the collaboration and relationship physicians have with industry, and rightly so.  In fact, three studies this year, which fall in line with APA’s rejection, showed no evidence that commercial support results in perceived bias in CME activities. Additionally, to date there is no empirical evidence to support or refute the hypothesis that CME activities are biased and the available data by no means demonstrate conclusively that commercial funding unduly biases continuing professional education.

As a result, the APA has recognized the importance of letting doctors choose from all sources of information the best data to share with their patients by letting psychiatrists become aware of their “conflicts” and manage them independently, without needless guidance on how to do either.  One of the prerequisite for becoming a psychiatrist is medical school and extensive residency training, so we should consider that they are all adults.  In doing so, APA has removed the unnecessary stigma associated with working with industry and has instead given psychiatrists the necessary freedom to learn about new treatments and drugs to help patients overcome their illnesses.

APA has also shown that media criticism and loud protesters (The APA is one of those meetings that gets protesters) do not replace the real scientific evidence, which shows that industry-physician relationship is beneficial to patients and physicians.  As one participant noted, many physicians go to the Annual meeting to “get education” (CME) because “whether it’s good education or bad education (in someone else’s opinion), it’s all education.”

Ultimately, the APA Assembly’s rejection of proposals that hinder and limit interactions with industry should be applauded.  Other medical societies and organizations should follow in their footsteps and acknowledge the important role industry-physician relationships play in helping develop innovations in medicine and technology, which lead to better treatment and outcomes for patients.