Stanford University School of Medicine in a letter to their Faculty announced they will no longer accept support from pharmaceutical or device companies for specific programs in continuing medical education, as industry-directed funding may compromise the integrity of these education programs for practicing physicians, officials said.
The action on CME builds on a 2006 policy that banned gifts, including free meals, and industry marketing at the Stanford University Medical Center.
Stanford is one of the few U.S. medical schools to enact such restrictions, which go into effect September 1. One reason behind all this is that Stanford is able to afford such a policy with a huge endowment and large signing bonuses for faculty.
The policy is being implemented as part of the school's ongoing review, begun in 2005, of its interactions with industry in the educational and clinical arenas.
Continuing medical education programs are designed to help physicians stay current in their fields and are legally required for them to remain licensed to practice medicine.
Under the new guidelines, the school may accept commercial support for CME only if it is provided for broad areas, such as medical, pediatric and surgical specialties; diagnostic and imaging technologies; and health policy and disease prevention.
Funding must not be linked to a specific course, topic or program. In addition, commercial exhibits will no longer be permitted at Stanford-sponsored CME activities on or off campus.
In announcing the latest decision, Dean Philip Pizzo, MD, said he believes CME programs can be true to the School of Medicine's goal of improving quality and clinical outcomes only if they are free of commercial influence.
This may be an empty gesture. In fiscal 2006-07 about 38 percent of the school's budget for CME, or $1.87 million, came from industry sources. Stanford’s endowment is over 17.1 billion dollars, $1.87 million loss amounts to less than a ½ day’s interest at 5%.
In their press release they are quick to point out that some find this to be a worrisome trend. In June, the American Medical Association's Council on Ethical and Judicial Affairs issued a report urging individual doctors and medical institutions not to accept industry support for CME, saying it could "threaten the integrity of medicine's educational function”.
· The CEJA Report was soundly rejected by the AMA house of delegates, yet the poorly researched and written report is used as a basis for restricting CME at Stanford.
They then go on to quote the Macy Foundation, "A conference of medical professionals convened in 2007 by the Josiah Macy, Jr. Foundation similarly concluded that because of industry's involvement in CME activities, "Bias, either by appearance or reality, has become woven into the very fabric of continuing education" for physicians.
· The Macy Report which is also quoted was simply opinions not backed up by evidence and summarily rejected by the major healthcare accrediting bodies of the ACCME, ACPE and ANCC.
Industry funding of CME activities also has been called into question by Congress, with two Senate committees reviewing the issue.
· Congress has called into question funding but limited to direct funding on behalf of a practicing physician not the overall funding of activities. One Senate Committee (Finance) finished a report in 2007 with the recommendation for more diligent enforcement of the current rules, the other committee Aging is currently reviewing the issue.
"Under the present system, in many circumstances a CME course will be held only if a commercial company is willing to sponsor it,"' said Robert Jackler, MD, the medical school's associate dean for CME.
· This really is a problem for a university like Stanford, it shows the previous lack of commitment from the University for their CME department, I would be curious to see if they add more funds to underwrite programs themselves.
As quoted in the NY Times Dr. Murray Kopelow, chief executive of the Accreditation Council for Continuing Medical Education, said that Stanford’s new policy was part of a growing push in medical education to further separate crucial medical information from marketing messages.
“It’s a good plan, and it’s a big deal that a place like Stanford has adopted it,” Dr. Kopelow said. “When this is all over, medical education will not be the same as what it’s been.”
Is this a sign that the ACCME is committed to ending commercial support of CME? What does Dr. Kopelow mean when he says “When this is all over”?
This is one additional reminder that our voices need to be heard.
New York Times Article: “Stanford to Limit Drug Maker Financing”
Pharmalot: Stanford University to Restrict CME Financing
Stanford:
A New Policy on the Use of Industry Support for Continuing Medical Education (CME)