At its Board of Directors meeting Saturday, the American Association of Clinical Endocrinologists (AACE) endorsed a statement that endocrinologists have a greater responsibility than ever to educate physician colleagues, allied health professionals, and patients on the most up-to-date treatments and guidelines in endocrinology.
The statement came in response to two recent events that made headlines. First, it was reported earlier last week that the number of Americans with diabetes might double in the next 25 years. As a result, AACE asserted the need to educate physician colleagues because of the worsening national epidemic of poorly controlled diabetes and metabolic diseases, the shortage of endocrinologists to treat these conditions, and the rapid expansion of therapeutic innovations that can improve patient outcomes.
AACE also appears to be making this statement in response to the recent publication of payments from industry to physicians for education, reported by ProPubilca. Specifically, AACE asserted that “ongoing education in new medications and devices is necessary for their safe and effective use, especially in complex diseases like diabetes.”
Accordingly, they recognized that “educational presentations provide the scientific background, the data, and the reasoning to understand new treatment options and make better use of old ones.” What is important to realize about this point is that many health care practitioners do not have the time to go through mountains of journal and thousands of articles to find the latest and greatest breakthroughs in patient treatment. Medicine is ever changing, and educational presentations provides health care providers with concise and focused materials on the needs and gaps in care of particular diseases or areas. These programs are intended to influence their practice and improve patient outcomes, and as AACE further recognized, to make “this education accessible it must take place in as many settings as possible, and when sponsored by industry it operates under very strict rules of conduct.”
AACE explained that educators “spend many hours preparing their presentations, taking time away from their practices, and traveling in order to participate in educational programs.” This quote recognizes the role health care practitioners provide in creating the content for continuing education programs, and the sacrifices they take, making their fair compensation understandable and reasonable.
AACE further asserted that the “legitimate concerns surrounding the abuses of a limited number of physicians should not undermine a fundamental tenet in the practice of medicine – the commitment to the lifelong study and furthering of medical knowledge required to continuously improve patient care.” AACE’s own commitment to lifelong study and furthering of medical education was reflected in a position statement in 2009, the ethical collaboration between physicians and industry. The statement maintains that “there is no inherent conflict of interest in the working relationship of physicians with industry and such work has resulted in many medical advancements and improved health outcomes.”
Given the status of health care and medical education, AACE made three important points to support their position that commercially sponsored education and accredited CME is important. First, given that there are too few endocrinologists to treat worsening epidemic of diabetes and metabolic disease, it would be counterproductive and extremely problematic to current patients to reduce education on breakthroughs and guidelines for treatment in these areas. Furthermore, given the increasing number of patients being added into the health care system through health care reform, this problem will only be exacerbated.
AACE recognized that new therapeutic options and guidelines to treat disease require education for safe and effective use, and therefore eliminating sources or stigmatizing sources of education because they are commercially supported will only result in less informed health care practitioners.
AACE asserted that educational programs, including those sponsored by industry, expand the number and types of health professionals who can effectively treat patients with diabetes and metabolic diseases.
AACE recognizes the need for commercial support of education to keep health care practitioners informed and to help improve outcomes of patients. Other professional associations and organizations should examine the concepts that AACE has adopted in support of commercially funded education to recognize that many of these principles are consistent in all areas of care. Patients with chronic diseases and rare diseases demand that health care practitioners learn about new therapeutic options and guidelines to treat disease, and in some diseases such as cancer, these treatments are often the gold standard of care. Accordingly, other specialty groups owe it to their patients to show their understanding and to consider the benefits of commercially funded education and accredited education.