July 1, 2010

Concerns over pharma influence on continuing med education go back decades

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To a medical historian, especially one who tracks the pharmaceutical industry as Jeremy Greene of Harvard does, last week’s Georgetown conference, “Prescription for Conflict: Should Industry Fund Continuing Medical Education (CME)” must have seemed like a flashback.

In his conference talk, Greene gave some of the history of concerns over such industry influence. He’s also published on the topic. In this article, for example, he cited Pediatrics journal editor Charles D. May, who warned in 1961:

A vicious cycle is created by a mad scramble for a share of the market: the doctor is made to feel he needs more “education” because of the prolific outpouring of strange brands but not really new drugs, produced for profit rather than to fill an essential purpose; and then the promoter offers to rescue him from confusion by a corresponding brand of “education.”

And, while, Senator Chuck Grassley gets a lot of headlines today for his Senate Finance committee investigations into drug company influence on doctors and CME, we may forget the history of past Senate hearings on these issues.

From 1959-1962 Senator Estes Kefauver led historic hearings.

Then, as Greene writes, when there were implications of a firewall between the business and editorial functions of CME:

“…ample evidence of the porousness of these firewalls existed as early as 1976, sufficient to prompt a series of hearings into the subject led by Sen Gaylord Nelson (D, Wisconsin).
…
Despite such hearings, the influence of medical education and communication companies continued to increase throughout the 1970s and 1980s. By the early 1990s, the subject emerged again in another set of hearings–now chaired by Sen Edward Kennedy (D, Massachusetts)–provoked by increasing reports of extravagant marketing practices by the pharmaceutical industry.”

He who ignores the past is doomed to repeat it.

In an interview, Greene said the ’70s became a turning point.

In that clip, he used the term MEC – which stands for Medical Education Collaborative – which is an organization that provides continuing medical education.

Correction: Dr. Greene advises that it’s actually MECC – for “Medical Education and Communication Company.”

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