Nissen: ACCME should be abolishedThe ACCME is a toothless watchdog and should be abolished, said Cleveland Clinic's Dr. Steven Nissen at a Senate Committee on Aging hearing.
The accrediting body is “uninterested or incapable” of enforcing its own rules, said Nissen, who groused that he had written letters to ACCME complaining of bias in continuing education but hadn't received so much as an acknowledgment. “Whatever ACCME is doing is ineffective,” said Nissen. “We need ACCME to go away and we need to replace it with something else.” He said industry-funded CME is a huge driver of healthcare costs, estimating that the government could save $900 billion over 10 years on unnecessary prescribing of branded drugs—in part through curbing bias in continuing education. “That's one of the ways we can pay for healthcare reform,” said Nissen.
ACCME chief Dr. Murray Kopelow defended his organization at the hearing, detailing tougher guidelines that the group has instituted in recent months and saying that the lax practices described by critics “is in another time and another place.” But conflict-of-interest hawks far outnumbered defenders of the CME profession, and the event had the feel of a pile-on, as speaker after speaker painted a bleak picture of a CME enterprise that comingles marketing and education, and senators questioned the value of commercial support.
Lew Morris, general counsel at the Department of Health and Human Services' Office of the Inspector General, suggested that eliminating commercial support altogether was “appealing for its purity and simplicity,” and said drug and device companies must separate grant-writing functions from sales and marketing and eliminate any control over speakers and content—seemingly oblivious to the fact that they have already done so.
Eric Campbell, of Harvard Medical School and the Institute of Medicine conflict of interest committee, said “the current system of funding is unacceptable and should not continue.”