Once again, the fact that the pharmaceutical industry helps financially support continuing medical education programs is in the spotlight. This time, the spotlight focuses on the College of Family Physicians of Canada (CFPC), where a small group of physicians are reiterating all of the partially misleading, and somewhat nonsensical, sound bites we have heard time and time again. Instead of again focusing on those accounts, we will instead focus on the good work the CFPC is doing, and the actions they have taken as a result of a 2010 Task Force review.
In 2010, the College of Family Physicians of Canada established a Task Force to review the CFPC’s relationship with the healthcare and pharmaceutical industries (HPI), and to make recommendations about the College’s relationship with HPI.
Task Force Results
The Task Force recognized the importance of industry financial assistance, and therefore made some of the following recommendations to the CFPC, some of which have been taken under advisement, and others that have been implemented. This is by no means a complete list of precautions the CFPC takes, but an overview.
Conflict of Interest (COI)
The Task Force recommended that the CFPC set out explicit and defined conflicts of interest in the CFPC’s relationships with the HPI. Additionally, the Task Force recommended that where the scope and responsibilities of CFPC positions are broad, a judgment must be made to confirm if a disclosed COI rises to the level of preventing the individual from carrying out high-level roles such as Committee Chair, Section Chair, CFPC Executive, and Chapter Executive.
Financial Relationships
The CFPC must be explicit about, and in control of, the financial relationships it undertakes with HPI. For one, sponsorship terms must be publicly declared and requests to initiate or continue a sponsorship relationship must be assessed for impact on the CFPC’s reputation. Additionally, the sponsorship of any food or other “gifts” from accredited educational activities will not be linked back to the HPI.
Access to Information
Several of these recommendations related to the CFPC website, and recommended that the website be used to post information related to the disclosure of relationships with HPI for members to review, as well as some public information on how the CFPC manages their relationships with the HPI.
CFPC Pushback
Dr. Jennifer Hall, the president of the CFPC, and Dr. Francine Lemire, the executive director and chief executive officer of the CFPC, together wrote a well thought-out response to the critics, focusing on how critical private sponsorship of continuing professional development is to Canadian physicians. As they state, “unlike medical undergraduate or residency education, continuing education receives almost no public funding.” This lack of funding makes it difficult for physicians to afford and attend the continuing education courses required, and as such, the pharmaceutical industry has stepped in to fill the void in the funding vacuum.
Doctors Hall and Lemire set the record straight when they state that the CFPC Board has considered, on more than one occasion, whether to eliminate the healthcare and pharmaceutical industry-supported program, and that they have not done so because doing so might result in less high-quality opportunities for Canadian physicians to learn.
The CFPC has taken steps to mitigate the influence of pharmaceutical companies on the annual scientific program at Family Medicine Forum, as well as clearly articulate what counts as education versus what is considered to be marketing. The CFPC has changed their vetting guidelines and requirements for prospective exhibitors for their annual Family Medicine Forum in order to ensure transparency and clarity about the exhibitors’ relationships with the healthcare and pharmaceutical industry.
Additionally, at the 2016 Family Medicine Forum, the Exhibit Hall will be clearly labeled “marketplace” so attendees are “acutely aware” that exhibitors are marketing their products and services in there. CFPC even went one step further, allowing attendees who are disinterested in any of the exhibitor’s products and services to avoid the marketplace altogether by placing food and meals in a different location, away from the Exhibit Hall.
Lastly, Doctors Hall and Lemire highlighted the fact that the CFPC’s peer-reviewed journal, Canadian Family Physician, carefully screens all advertisements and has a strict policy on the proximity of ads relative to editorial content.
In addition to the restraints already in place, the Task Force helped the CFPC to come to the conclusion that creating a continuing professional development program development fund might be a potential way to support the development, dissemination, and evaluation of accredited educational activities. This fund would include contributions in the form of subscriptions to access high-quality continuing professional development or unrestricted donations to the Research and Education Foundation.
Conclusion
In short, most patients enjoy knowing that the doctor who is taking care of them and their family has fulfilled continuing medical education requirements, and that the physician has knowledge about the most recent developments in healthcare. Industry support of the continuing education of the physicians who take care of our families is one of the main reasons we have such a thriving healthcare industry and a contributor to long life expectancy. High-quality continuing medical education is crucial to the continuation of such success, and industry financial support is just one of the important ways the success will continue.