CONTINUING MEDICAL EDUCATION
Medicine at Cleveland Clinic, stated in his testimony before the Senate
Committee on Aging in 2009, MECCs provide a “veneer of independence”
that hide the promotional nature of CME programming. 105 The brochures
often state that the program was funded through an unrestricted educational
grant from the sponsoring company, even though the MECCs often select
speakers and topics that they know will please the companies funding their
activities. 106 In fact, Pfizer and GlaxoSmithKline ceased their funding of
CME programming organized by for-profit MECCs to avoid the appearance
of impropriety due to suspect relationships that had developed between
MECCs and industry. 107
Despite the fact that the ACCME has updated its accreditation
requirements and standards for commercial support several times over the
past decade, the organization has not enforced the standards. 108 Data shows
that CME providers have breached the ACCME standards. In 2007, the
ACCME found that one in four of its accredited CME providers was openly
breaching ACCME guidelines. 109 The ACCME’s role in restricting
commercial bias is limited. It does not preapprove CME content and
routinely does not monitor CME programs. 110 Oversight is largely after the
fact; it occurs once ACCME learns of a complaint concerning a
noncompliant CME activity. 111 Furthermore, the ACCME’s safeguards
cannot detect when a drug company plants an individual in the audience at a
CME event to ask a particular question about a drug, to ensure that the
discussion includes that drug. 112 Moreover, the ACCME’s primary
enforcement tool is revocation of a CME provider’s accreditation, which
may occur for until significantly after the noncompliance. 113 To monitor
bias in CME, the ACCME requires providers to survey participants about
commercial bias at the conclusion of events. 114 Participants, however, may
not be in the best position to detect the bias.
107. See Janice Hopkins Tanne, Pfizer Stops Funding Medical Education Run by For-Profit Companies, 337 BMJ 73 (2008). It is important to note that MECCs can be
significant resources; for example, they can supply well-trained staff who provide high
quality CME programming. See INST. OF MED., supra note 1, at 72.
108. See, e.g., Nissen Testimony, supra note 11.
109. BRODY, supra note 26, at 319-20.
110. Morris Testimony, supra note 18.
112. INST. OF MED., supra note 1, at 72.
113. See id.; see also Morris Testimony, supra note 18 (noting that in one case up to
nine years elapsed between identification of noncompliance with ACCME standards and
revocation of a CME provider’s accreditation).
114. INST. OF MED., supra note 1, at 72.