Michael Moore on California’s Single Payer Proposal
Daniel Carlat, a professor at Tufts Medical School, and editor in chief of The Carlat Psychiatry Report, wrote a telling op-ed in the New York Times a few weeks ago.
In it, he argues that pharmaceutical involvement in doctors’ continuing medical education is having dangerous side effects for the very simple reason that the dangerous side effects of various drugs rarely make it onto contemporary curriculums.
Most states require that doctors obtain a minimum number of credit hours of continuing medical education each year to maintain their medical licenses. Not so long ago, most of these courses were produced and paid for by universities and medical associations. But this has changed drastically over the past decade.
According to the most recent data available from the national organization in charge of accrediting the courses, drug-industry financing of continuing medical education has nearly quadrupled since 1998, from $302 million to $1.12 billion. Half of all continuing medical education courses in the United States are now paid for by drug companies, up from a third a decade ago. Because pharmaceutical companies now set much of the agenda for what doctors learn about drugs, crucial information about potential drug dangers is played down, to the detriment of patient care.
On the face of it, this seems to be a conflict of interest, and a precursor to bad medicine. Carlat mentions as much, writing how Merck promoted Vioxx through various CME programs, just as GlaxoSmithKline promoted the now-troubled Avandia while downplaying both the drug’s side effects on the increased levels of lipids associated with heart disease, and a competitor’s drug (Takeda Pharmaceuticals’ Actos) that actually improves lipid levels.
While the Accreditation Council for Continuing Medical Education prohibits pharmaceutical companies from directly paying doctors to teach CME courses, the industry’s not so very hidden secret is that they simply pay a third party, who, in turn, pay the doctors.
Carlat’s idea to close this loophole is relatively straightforward:
The solution could hardly be simpler: any continuing medical education that is paid for by the drug industry should not be accredited. Drug companies could still pay for any educational event, article or pamphlet they choose, but their courses and materials would no longer bear the imprimatur and implied credibility of accreditation.
Doctors, in turn, would be encouraged to seek medical education from sources that are not financed by drug companies. A renewed commitment to unbiased education would allow doctors to learn about drug risks sooner. This would be good for doctors, and even better for their patients.
Sounds reasonable, and the guidelines for commercial support of CME are being reviewed after a report released by the Senate Finance Committee drew attention to the problem.
We’re cautiously optimistic as we await the results.
Michael Cervieri is ScribeMedia.Org’s Executive Producer and host of the HealthDot Pharma Report.
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