Physician leaders push back on policy barring industry speakers from talks

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A policy barring pharmaceutical industry employees from giving continuing medical education talks at meetings has elicited strong opposition from physician leaders.

After being told that the American Heart Association will not be allowed to feature industry speakers on the podium at its big annual meeting later this year, AHA president Clyde Yancy was said to be aggressively appealing the policy, which was set by ACCME in a 2009 clarification of its standards for commercial support and related to Yancy at a recent NIH meeting.

“We were told we could not integrate the science (from industry employees) into any sessions…,” Yancy said in comments from the NIH meeting which were first published in the Milwaukee Journal Sentinel. “We could not invite speakers to be on our programs unless they were in a separate venue. And we could not portray the work unless it was in a separate geographic location from other CME.”

Yancy, a cardiologist, is not the only high-profile physician who has expressed opposition.

“The policy is blood-curdling,” said Keith Yamamoto, executive vice dean of the University of California, San Francisco School of Medicine, also at the NIH meeting. “This is conflict-of-interest considerations run amok.” Francis Collins, director of the NIH, found it disturbing as well: “It is a breathtaking sweep to squash something that is really important to us, the science going on in the private sector.”

Others quoted in the Journal Sentinel said the ACCME decision was a sound one, including James Stein, a University of Wisconsin cardiologist who said talks given by industry members are typically part of a strategic marketing plan, stripped of any unflattering data about their company's product. And Adriane Fugh-Berman, a critic of industry funding and a physician who teaches physiology and biophysics at Georgetown University, said it's hard for a researcher to be objective when discussing a drug they have studied.

Still, the high-level opposition could prove to be a tipping point, some say, in the war of words over drug industry influence in continuing medical education.

“I'm hoping it may be the beginning of widespread recognition by academic and other physician leaders that the conflict of interest programs have gone too far, and this might be an opening bell of some significant push back by opinion-leader doctors,” said John Kamp, executive director, Coalition for Healthcare Communication. “This has all happened without the titans or the rank-and-file leaders of organized medicine paying much attention. And the fact that a couple of them found it just breathtaking is a good sign.”

If more doctors were to speak up, that would be a welcome development, said Tom Stossel, the Harvard Medical School professor who took a lonely stand in support of industry sponsored CME at a Senate hearing last year. “Up until now, the problem has been that the people doing the innovating, educating and treating of patients in the rank and file are so preoccupied… It's the prominent researchers and physicians who have collaborated, who have made a lot of money, who have to start speaking out, because they have done something. The critics have, with rare exceptions, done nothing to contribute to education or innovation.”
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