Yesterday, a “Brief Report” was published on the JAMA website titled Medical Communication Companies and Industry Grants. I have a few issues with the report and plan to write a more thorough response to the article with a few of my CME colleagues in the near future.
In addition, lead author Sheila M. Rothman, PhD did a brief interview with news@JAMA, which you can read here (no paywall). I would like to offer a quick response to one of the comments Dr. Rothman made on how “medical communications companies” work. Here is the question from news@JAMA and Dr. Rothman’s reply:
news@JAMA: How do medical communications companies work?
Dr Rothman: These organizations are fairly obscure and haven’t been studied. They essentially are groups that provide information they get from pharmaceutical companies and give it to consumers and physicians. They also take information from consumers and physicians and “give” it back to pharmaceutical companies.
A few points:
1) There is a difference between certified-CME and promotional education. Medical communication companies do promotional education programs. Medical education companies do certified-CME programs (the ACCME defines them as “publishing/education companies”). The companies listed in the JAMA report are ACCME-accredited medical education companies doing certified-CME programs. They do not do promotional education. They are not allowed to. This is an important distinction.
2) Just because you have never heard of something doesn’t mean it’s “obscure”. Medical education companies have been around for many years and are quite familiar to a lot of people. I never heard of Weibo until a few days ago. Half a billion registered users tells me it’s hardly obscure.
3) Medical education companies – and those that work there – do not “provide information they get from pharmaceutical companies and give it to consumers and physicians.” Developing certified-CME activities in this manner is a direct violation of the ACCME’s Standards for Commercial Support and would lead to a CME provider losing their accreditation status. There are strict regulations with regards to the communication between CME providers and pharmaceutical companies about the content of CME (to be specific: they can’t talk about it, period.) These are the same standards hospitals and academic medical centers and all other provider types are held to. I would even venture to say that since most medical education companies are aware they are highly scrutinized due to perception biases, they frequently hold themselves to an even higher standard. The content of certified-CME activities does not come from pharmaceutical companies. This may have been more of an issue 10-20 years ago, but it’s not how it works now.
4) Yes, medical education companies do “take information from consumers and physicians and ‘give’ it back to pharmaceutical companies,” but not the information implied by this article. The information given to pharmaceutical companies are outcomes reports based on evaluation and pre/posttest data from specific CME activities. These reports summarize various levels of participant outcomes for the specific activity, ranging from satisfaction with the quality of the activity to how they have used the information from the activity in their practice. Frequently, these reports include a summary of participant demographics: physicians vs non-physicians, areas of expertise, number of years in practice, etc. Personally identifiable participant information is not given to pharmaceutical companies. I cannot vouch for every single medical education company, but it is certainly not common practice. Ironically, this will unfortunately change due to the Sunshine Act. Reporting of personally identifiable information such as names, addresses, medical license number, etc, is now required for Certified-CME activities where a transfer of value, such as plated meals, is included. Don’t blame the medical education companies for this. Blame CMS.
These medical education companies have real people with real jobs working for them. It hurts me when I seem them being represented inaccurately. They deserve better.