A paper recently presented at the 2012 CME Congress in Toronto, Canada, May 30th – June 2nd looked at what would happen to oncology CME if commercial support were eliminated.
The Consequences of Diminishing Industry Support on the Independent Education Landscape – Oncologists
This paper was authored by John Ruggiero, PhD, MPA, CCMEP; Mazi Abdolrasulnia, PhD, MBA; Caroline Robinson, PhD; Stephen Burton, MS. It was supported by Genentech, Inc. and CE Outcomes.
Oncology is an area of rapidly changing medical evidence, and the public health consequences are high if there is a failure among US clinicians to translate evidence-based medicine (EBM) to clinical practice. This research aimed to examine the role of independent medical education in meeting the professional development needs of practicing oncologists.
In this research, the authors evaluated the perceptions of practicing US-based oncologists and oncology fellows to identify the discrete elements of CME that they consider of value when selecting CME programming, their perceptions of industry support of CME, and their perceptions of the impact of the removal of commercial support on the practice of EBM and related patient outcomes. The authors sought to identify the foreseeable long-term implications of diminishing industry support for CME among oncologists, in light of the ever-expanding innovation and emerging therapies that are the hallmarks of their field.
Twenty semi-structured interviews with US oncology physicians were conducted in September 2011; 10 interviews were conducted with oncology fellows, and 10 were conducted with oncologists in active practice. The aim of the structured interviews was to better understand the factors that influence oncologists’ decisions when selecting and participating in various CME programs.
From a literature review and the formative interview sessions, a survey instrument was developed to address the study’s primary research questions. The surveys were distributed via email and US priority mail to a nationally representative sample of US practicing oncologists and oncology fellows between November 18 and December 1, 2011. Surveys were completed by 283 oncologists and 85 oncology fellows. Variations among the choices selected by oncologists and oncology fellows were examined through the use of descriptive statistics. To validate and further describe the research findings, 11 confirmatory semi-structured interviews with practicing oncologists were conducted in December 2011.
“To be honest, industry support is the major supporter of CME in this country, and no one else is going to support it. Without it, there won’t be any CME, and it will definitely impact patient safety and patient outcomes. There is no doubt about it.” –Quote from practicing oncologist within research interview
Discussion
About half of oncologists perceive that the loss of commercial support for CME will have a negative impact on their application of new and emerging therapies within their practice due to the reduction in the number and speed of dissemination of CME on new and emerging treatments.
Oncologists are also concerned that diminished commercial support for CME would negatively impact the availability of professional development opportunities, particularly due to reduced access to a variety of CME formats and a limited range of relevant content options; rural oncologists are projected to bear the greatest brunt of reduced support.
Oncologists and oncology fellows appear somewhat reticent to agree that the lack of commercially supported CME will ultimately impact the practice of evidence-based medicine, patient safety, or patient outcomes. However, a segment within the oncology sample stated that the impact of the loss of availability and quality of oncology CME that would be expected to accompany a removal of commercial support for CME would necessarily impact patient care and outcomes.
Oncologists have a significant demand for high quality, innovative, easily accessible, and relevant oncology CME. Oncologists clearly value the support of industry in making available quality CME that offers timely information on innovations in oncology.
Oncologists appear to value commercial supporters’ engagement as asset partners in aiding oncologists to effectively sustain their specialized knowledge and skills and to provide the advanced medical practice that their discipline and their patients require.
“Oncology is the most rapidly developing field in medicine. New drugs or developments come out every 2 months. CME is the only way to stay up on the newest information.” —Quote from practicing oncologist within research interview
Practically all oncologists noted that if commercial support of CME/CPD were limited or removed, physicians in rural areas would face negative impacts on CME availability. Similarly, approximately 97% of oncologists said that attendance at national meetings would decrease due to cost if commercial support is limited or removed.
Approximately 88% of oncologists said it is somewhat to very likely that implementation of new/emerging therapies will be slower if commercial support is reduced, and 89% said implementation of evidence based-medicine would be slower. Guideline development would also be prolonged according to 81% of oncologists.
It is important to understand that eliminating resources from the system such as commercial support of CME can have negative consequences. Critics outline the discussion on elimination of company support as a no risk alternative. But elimination of information concerning potentially lifesaving therapies in areas such as oncology can have significant negative effects on patient health and is not a risk free proposition.