In the recent edition of the American Medical Associations CPPD Report, Todd Dorman, MD, Associate dean and director of the Office of Continuing Medical Education for Johns Hopkins University School of Medicine, wrote an article titled “CME: Ailing from a case of systemic inflammatory response syndrome.” Dr. Dorman also was a member of the committee for the Institute of Medicine (IOM) who released its recommendations in the report Conflict of Interest in Medical Research, Education and Practice, last April.
Dr. Dorman starts off by evaluating continuing medical education (CME) providers, planners and faculty today the way a doctor evaluates their patient. He noted that CME was enjoying a “usual state of good health until media, government and regulatory agencies began to question the veracity of CME programs and the transparency of their process.” Specifically, Dr. Dorman noted that the source of this questioning began with the recent investigations conducted by the Senate Finance Committee into relationships between physicians or medical researchers and pharmaceutical, medical device, and biotechnology companies.
The problem with these investigations is that all CME funding and programs are coming into question, when the investigations are focused “on individual physicians who have had discrepancies in disclosing payments.” So, because of a few, all patients and physicians are beginning to suffer.
The rest of Dr. Dorman’s article focuses on the IOM report he worked on because it “addressed a diverse set of circumstances and utilized the same principles to recommend improvements that would still protect and allow the great good that comes from interaction between the health care and industry sectors.” He also emphasized the IOM recommendation “that a COI committee exists within an organization’s management infrastructure.” Moreover, Dr. Dorman asserted that a standard approach for disclosure for every journal, CME provider, institution and national organization should be established.
His article also focused on the need of “training for all physicians by academic centers and teaching hospitals,” to educate doctors about the rules and regulations surrounding relationships and conflict management in cases relating to the CME world. Part of his belief for such training comes from the results of the Cochrane Collaboration and an AHRQ monograph on the effectiveness of CME, which both “found that educational meetings are effective.”
Ultimately, Dr. Dorman recommended that “the health care industry should work to reduce the stress and confusion surrounding the CME environment and COI by embracing the concepts within the IOM report.” In fact, it is crucial that industry work with CME because it is so “poorly funded by sources other than commercial entities. As a result, Dr. Dorman acknowledged that while such work is being done, “the community outside of health care should allow time to collect data” on how such changes affect CME because without such information “broad-based sweeping regulation is simply inappropriate at a time of such change.”