An Alternative POV On The Reduction Of Commercial Support in CME

This is a guest post from a colleague of mine in response to my The Unspoken Casualties Of Reducing Industry Support Of CME post from a few weeks ago. I wouldn’t call it a rebuttal; just an alternative point of view.

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I feel the need to go over SCS 101, since many of the terms are interchangeable and often misinterpreted.

Commercial Interest: A commercial interest is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

Relevant Financial Relationship: Defined as financial relationships {with an ACCME-defined commercial interest} in any amount occurring within the past 12 months that create a conflict of interest.  Personally, I feel that the word “relevant” should be eliminated.  If someone in control of content has a financial relationship with a commercial interest, then the CME provider should determine whether or not it’s relevant and creates a conflict of interest, not the discloser.

Conflict of Interest: The ACCME considers financial relationships to create actual conflicts of interest in CME when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the products or services of that commercial interest.  All conflicts of interest must be resolved prior to the start of the activity.

Note: A financial relationship with a commercial interest does not automatically create a conflict of interest unless the topic falls under the scope of the healthcare goods or services that are created, marketed, sold or distributed by the commercial interest.  However, just because a faculty member has slides reviewed, he/she can control content just by speaking/moderating/debating/etc.

Disclosure to the Provider: The individual controlling the content discloses their relevant financial relationships to the CME provider.

Disclosure to the Audience: The provider discloses to the audience all relevant financial relationships {or lack thereof} of all individuals who control content.  All conflicts of interest must be identified and resolved prior to this occurring.

Note: Disclosure to the Audience by the faculty member is not considered resolution, and is the responsibility of the provider.

Commercial Support: Commercial support is financial, or in-kind, contributions given by a commercial interest, which is used to pay all or part of the costs of a CME activity.

What is happening: People are freaking out about the reduction of industry support.  Organizations that relied heavily on commercial support are eliminating CME because they believe it is no longer financially feasible to support CME without commercial support.  The blame is being placed on industry involvement and not on the providers themselves for allowing industry to take a larger role.  Faculty and planners who have financial relationships are being penalized instead of utilizing the standards set forth by the ACCME.   People who care deeply about quality medical education- regardless of who is funding it- are losing their jobs for poor budget practices.

What should happen:  Stop using industry as a crutch.  Providers need to take responsibility for their CME.  Instead of begging industry to support the education and bending over backwards (sometimes in a manner that is non-compliant), create alternative revenue sources or stop having big-budget meetings.  Communicate with your learners- if they don’t want to pay top dollar, let them know that the education will be just as good in an Embassy Suites as it would be in a Ritz-Carlton.   (Nothing against either of those hotel chains).  Evaluate your faculty- regardless of their relevant financial relationships.  If they are demanding top dollar, find an effective yet cheaper faculty member.  It’s not like these faculty are creating their presentations from scratch.  They’ve probably presented a modified version of that presentation before.  Why should you pay them beaucoup bucks for unoriginal content?

It is the physician’s personal responsibility to ensure that the content they are controlling does not create a conflict of interest and is free from commercial bias, and it is the CME provider’s organizational responsibility to ensure that the content is not subject to a conflict of interest and is free from commercial bias.  Mere commercial support does not insert bias into educational content, biased faculty and planners do.

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One response to “An Alternative POV On The Reduction Of Commercial Support in CME

  1. I dig this alternative POV. As a former Provider, I’ve experienced the closings/layoffs/downsizing typical of the self-defeating financial/business models of some MECCs. It’s not just alternate sources of funding, it’s cost effective instructional design models and delivery methods that will improve access and quality of healthcare education.

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