441 It's About Time
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Dynamic Chiropractic – July 29, 2008, Vol. 26, Issue 16

It's About Time

AAMC Finally Addresses "Industry Funding of Medical Education"

By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher

It is no secret the drug companies have sunk their financial hooks deep into the medical profession. From free lunches to "funded" research, the drug companies essentially have bought an inordinate amount of influence over medical research, hospitals, medical doctors and medical students.

After much public outcry, the Association of American Medical Colleges (AAMC) "charged a special Task Force on Industry Funding of Medical Education with forging consensus principles to guide the AAMC and the leaders of medical schools and teaching hospitals in developing policies and procedures to manage industry gifting practices and financial support of their programs of medical education for students, trainees, faculty, and community physicians."1

The task force recently presented its findings in a report that clearly outlines the changes that must take place in order to relieve the medical academic community of this inordinate influence.

Here is a summary of their findings and recommendations:

Gifts to Individuals - The acceptance of any gifts from industry by physicians, faculty, staff, students and trainees should be prohibited.

Site Access by Pharmaceutical Representatives - Access should be restricted to nonpatient/nonpublic areas and by appointment/invitation only. Student involvement should be for educational purposes only and only under the supervision of faculty. Representatives should not be allowed to be present during any patient care interaction without prior disclosure to and consent by the patient, and then only to provide in-service training or assistance on devices and equipment.

Continuing Medical Education (CME) -To the extent educational programs for physicians are supported by any commercial entity, the programs should be offered only by ACCME-accredited providers according to ACCME standards.

Participation in Industry-Sponsored Programs - With the exception of research presentations, academic medical centers should strongly discourage faculty participation in industry-sponsored speakers' bureaus. If they do allow participation, they should develop standards that define appropriate and acceptable involvement.

Academic medical centers should require full transparency and disclosure by their personnel to the centers when participating in such programs and should require that payments to academic personnel be only at fair market value.

Academic medical centers should prohibit their faculty, students and trainees from the following:

  • attending non-ACCME-accredited industry events billed as continuing medical education;
  • accepting payment for attendance at industry-sponsored meetings; and
  • accepting personal gifts from industry at such events.

Regarding industry-sponsored scholarships and other educational funds for trainees:

  • Scholarships or other educational funds from industry must be given centrally to the administration of the academic medical center.
  • No quid pro quo should be involved in any way.
  • The evaluation and selection of recipients of such funds must be the sole responsibility of the academic medical center or a nonprofit granting entity.

Food -With the exception of food provided in connection with ACCME-accredited programming and in compliance with ACCME guidelines, industry-supplied food and meals are considered personal gifts and will not be permitted or accepted within academic medical centers or offsite.

Professional Travel -Accepting travel funds from industry, other than for legitimate reimbursement or contractual services, should be prohibited.

Ghostwriting -Allowing professional presentations of any kind, oral or written, to be ghostwritten by any party, industry or otherwise, should be prohibited.

Purchasing - Personnel with any financial interest in any particular manufacturer of pharmaceuticals, devices or equipment, or any provider of services, should be required to disclose such interests according to institutional policies and recuse themselves from involvement in purchasing decisions relevant to the conflicting interests. If that individual's expertise is necessary in evaluating any product, that individual's financial ties to any manufacturer of that or any related product must be disclosed to those charged with the responsibility for making the decision.

While these guidelines are a good start, one has to wonder why it took so long for them to be established. Was public outcry required before political medicine would move? Interestingly enough, a number of pharmaceutical representatives were members of the task force. It should be noted that "[T]he Task Force report and recommendations have been approved unconditionally by all Task Force members, with the exception of Jeffrey B. Kindler (Pfizer), Kevin Sharer (Amgen), and Sidney Taurel (Lilly)." Needless to say, the drug companies don't want these guidelines put into place.

Ultimately, that's the problem with these guidelines - they have no teeth. There is no penalty for institutions/providers who continue to sell their souls to the drug companies.

Reference

  1. Industry Funding of Medical Education: Report of an AAMC Task Force, June 2008. https://services.aamc.org/Publications/showfile.cfm? file=version114.pdf&prd_id=232&prv_id=281&pdf_id=114.

Click here for more information about Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher.


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