I read Sue Pelletier’s very nice piece on The Disclosure Dilemma – where she quotes J. David Haddox, DDS, MD, who keynoted this year’s 23rd Annual Conference of the National Task Force on CME Provider/Industry Collaboration as saying, “I am human. Therefore, I am biased.” – and came to a conclusion: the issue the CME community really faces in regards to the disclosure of conflicts of interest, is one of trust.
We all have our biases and to try and categorically collect and list them all seems, to me, nigh impossible. Does reading through a speakers list of possible COI’s help us to trust them anymore or any less? Perhaps, but I’m not so sure that it should. We have all heard wonderfully balanced and educational presentations from speakers whose disclosure listings ran a mile long. On the other hand, we have also heard incredibly biased sessions from someone claiming to have nothing to disclose – and maybe they legitimately didn’t. Maybe their bias came from an incident with a family member 5 years before that we couldn’t possibly know about. Should we be asking that all of these personal biases be disclosed, too?
I would argue that even more valuable than a national disclosure system (which WILL be a big help from an accreditation and paperwork perspective) would be a Faculty Bias Rating database. I realize the logistics of getting all CME providers to ask the same standardized question about their faculty – and then report that information back into the system – is pretty unlikely, but this is information that I think would be helpful to know. Say what you will about self-reported responses to subjective survey questions in CME programs, but the one thing I have found to be pretty reliable through 12 years of observation is that activity participants will quickly point out a truly bad, biased presenter.
If we had a national database that displayed bias ratings for faculty from CME programs around the country – NOW we’re getting a system that helps me determine the faculty I can trust. Yes, maybe Dr. Doofenschmirtz is on 20 speakers bureaus, but his bias rating has been stellar for every CME activity he’s presented at. Hmmm…Dr. Platypus has no relevant financial relationships, but her bias score is hovering right around mid-range (yes, I’ve been watching too much Phineas and Ferb with the kids…). Take it a step farther and put each faculty member’s National Bias Rating score beside their name on your CME front matter, and now we’re really giving our participants something they can use.
We need faculty that we can trust. We need faculty that will present balanced, unbiased CME. The challenge…is finding them.