IOM calls for new regime in funding
The Institute of Medicine (IOM) has called for the development of "a new system of funding accredited CME...free of industry influence" and ordered "a consensus development process" to be convened with the aim of proposing such a funding system within the next two years.
In an interview with MM&M, Dr. Bernard Lo, MD, chair of the committee, acknowledged that evidence of industry bias in certified and accredited CME "is weak in either direction," and that ACCME documentation indicates high compliance from medical education and communication companies, but said the jury's still out on whether industry support influences topic and content selection.
"We're calling for more evidence rather than empty accusations," said Lo, who directs the medical ethics program at UC San Francisco. "We were not persuaded that the process now in place really assures a lack of bias. We think the burden should be on the providers to demonstrate independence."
The committee pointedly did not call for an end to industry funding, without which Lo acknowledged registration fees could be prohibitively high. He said some variation of a "bucket" approach, in which companies pooled grants into a blinded fund to be administered by a third party, might be one solution. Alternately, companies might contribute to programming not specific to a medication or condition and including non-pharmacological approaches to treatment. The aim, he said, is that topic, content and speaker selection should be unassailably shielded from influence.
Lo said the committee's chief concern in that area was that medical schools might be tainted by faculty participation in promotional speaking—"that a formal curriculum can be undercut by an informal curriculum or poor role modeling," he said. "We want to separate academic and educational speaking from promotional speaking."