Banning certain authors from writing books and giving talks doesn't seem to accord with freedom of speech, but that is exactly what the ACCME is proposing.( I thought that's what intolerant societies do, not the USA!)
This week the Accreditation Council for Continuing Medical Education released an additional call for comment (after they said they were done for the summer).
This call centers around the use of free lance writers and speakers that may also be involved with promotional activities.
The ACCME Standards for Commercial SupportSM stipulate that commercial interests cannot control the content of continuing medical education. The people within ACCME-defined commercial interests cannot control the content of continuing medical education. This further defines the independence of continuing medical education.
The ACCME now finds that there are individuals who are directly involved in the promotion of products and services of commercial interests but who are not employees of the commercial interests, e.g., medical writers who create promotional material for FDA-regulated firms or physicians who are paid by commercial interests to deliver promotional content to other physicians. Some of these same writers may be involved in writing or editing the content of accredited CME activities. Some of these same physicians go on to control the content of accredited CME activities on the same subject for which they have been paid to deliver promotional content.
They quote the Recent Merck Settlement with the States Attorneys as justification for this action, stating: In May 2008, the Attorney’s General of thirty U.S. states won a judgment against a commercial interest that included the stipulation that a promotional speaker for that commercial interest could not also be a CME speaker on the same class of drugs discussed in the promotional activity.
Is this what the settlement stated? Well, not exactly. This is the language of the settlement:
Merck shall comply with ACCME Standards for Commercial Support:
A) Merck will include in their promotional speaker contracts a pledge that if the speaker has worked for or received compensation from Merck in the therapeutic category the program concerns in the last 12 months, the speakers will:
Disclose to participants orally and to the CME provider for inclusion in the written materials:
i. The existence
ii. Nature
iii. Purpose of their arrangement with Merck
iv. Type of promotional work engaged
B) Merck shall not fund a CME program if at the time of funding decision they had knowledge that a speaker had also been a promotional speaker in the last 12 months at a Merck-sponsored promotional event related to the class of drugs to be discussed in the activity.
It called for disclosure of the speaker's conflicts and that at the time of the decision Merck could not fund a program if they had knowledge that a promotional speaker was included in the faculty.
They also included text from the recent Task Force on Industry Funding of Medical Education of the Association of American Medical Colleges report. It stated, “…academic medical centers should make clear that participation by their faculty in industry-sponsored speakers’ bureaus should be strongly discouraged.”
"Strongly discouraged" is different than an outright ban on speakers who speak at both types of activities. Frankly, this proposal would discourage many of the top medical experts, those with the most experience, from participating in CME programs.
I am sure that many organizations will be in the coming weeks providing comments to this and the other documents they posted in June. If the ACCME continues to make it more difficult for providers to comply with their edicts, in the end there will be less educated medical professionals. And I don’t know about you, but I want my physician or surgeon to know more not less.
If you think bias is the problem — is censorship the answer?