CONTINUING MEDICAL EDUCATION
Manufacturers Association (PhRMA) Code, also play a role in creating an
environment that limits industry bias in CME. 17 Because these other
guidelines are only voluntary, however, their effectiveness is limited.
Finally, while the federal government is restricted from regulating CME
content beyond off-label promotion, it can require full disclosure of
industry payments to physicians through the Physician Payments Sunshine
Act (PPSA). This legislation, too, is limited in curbing industry influence,
as the final regulations do not require disclosure of industry payments to
accredited CME providers. This section defines CME and explains the
various forms of industry bias before discussing each of these sources of
CME regulation and its effectiveness in curbing industry bias in CME
A. What is CME?
Graduating from medical school and completing residency mark the first
steps in a physician’s career-long commitment to education. 18 Physicians
obtain this continued education through CME programs. CME consists of
presentations and discussions on specific treatments and developments in
medicine and helps physicians and other medical professionals obtain
information and insights that can improve patient care. 19 CME is required
by most state licensing authorities in order for physicians to maintain their
medical license. 20 Hospitals and other institutions may impose additional
CME requirements on physicians who practice at their facilities. 21
Many CME programs are either partially or fully subsidized by
pharmaceutical and medical device manufacturers whose products are often
related to the topic of the CME program. 22 Therefore, CME can provide an
effective forum through which industry sponsors market their products and
increase prescriptions for their products. Drug companies’ interests,
17. See generally PHARM. RESEARCH & MFRS. OF AM., CODE ON INTERACTIONS WITH
HEALTHCARE PROFESSIONALS 1, 6 (2009) [hereinafter PHRMA CODE], available at
18. Medical Research and Education: Higher Learning or Higher Earning?: Hearing
before the S. Special Comm. on Aging, 111th Cong. 1 (July 29, 2009) (statement of Lewis
Morris, Chief Counsel to the Inspector Gen., Dep’t of Health & Human Servs.) [hereinafter
Morris Testimony], available at https://oig.hhs.gov/testimony/docs/2009/07292009_oig_
19. See AM. MED. ASS’N, THE PHYSICIAN’S RECOGNITION AWARD AND CREDIT SYSTEM 2
(2010), available at http://www.ama-assn.org/resources/doc/cme/pra-booklet.pdf.
20. See generally AM. MED. ASS’N, STATE MEDICAL LICENSURE REQUIREMENTS AND
STATISTICS 53-56 (2010), available at http://www.ama-assn.org/ama1/pub/upload/mm/40/
21. Id. at 1.
22. See ACCME ANNUAL REPORT-2012, supra note 5, at 10.