Friday 5 September 2008

Stanford Medical School Severely Restricts Industry Funding Of Continuing Education For Physicians

�The Stanford University School of Medicine will no longer assume support from pharmaceutical or device companies for specific programs in continuing medical education, as industry-directed financial support may compromise the integrity of these education programs for practicing physicians, officials said.


The action on CME builds on a 2006 policy that banned gifts, including free meals, and industry marketing at the Stanford University Medical Center.


Stanford is one of the few U.S. medical schools to ordain such restrictions, which go into gist Sept. 1. The policy is organism implemented as part of the school's ongoing revaluation, begun in 2005, of its interactions with industry in the educational and clinical arenas.


Continuing medical education programs are designed to help physicians ride out current in their fields and ar legally requisite for them to remain licensed to practice medicine. Under the new guidelines, the schoolhouse may accept commercial living for CME only if it is provided for broad areas, such as medical, paediatric and surgical specialties; symptomatic and tomography technologies; and health policy and disease prevention. Funding must non be linked to a specific course of action, topic or program. In addition, commercial exhibits will no yearner be permitted at Stanford-sponsored CME activities on or off campus.


In announcing the up-to-the-minute decision, Dean Philip Pizzo, MD, said he believes CME programs can be true to the School of Medicine's goal of improving timbre and clinical outcomes solely if they are loose of commercial influence.


"I want to be able to honor the world trust," Pizzo said. "We want CME to be unbiased and science-driven, and we don't want it to be influenced by marketing. We want our educational activities for whomever we are serving-whether it's our own faculty or our colleagues in the community, locally or globally-to be true to the science and the grounds, and not be influenced by whatsoever kind of financial industry support."


In recent old age, the pharmaceutic and medical-device industries have been a growing source of financial backing for CME programs. Between 1998 and 2006, industry funding for CME activities nationwide rose from $302 million to $1.2 billion, according to the Accreditation Council for Continuing Medical Education.


Some find this to be a worrisome trend. In June, the American Medical Association's Council on Ethical and Judicial Affairs issued a report urging individual doctors and medical institutions not to have industry documentation for CME, saying it could "jeopardise the integrity of medicine's educational purpose." A conference of medical professionals convened in 2007 by the Josiah Macy, Jr. Foundation similarly all over that because of industry's involvement in CME activities, "Bias, either by appearance or reality, has turn woven into the selfsame fabric of continuing education" for physicians. Industry financing of CME activities likewise has been called into question by Congress, with two Senate committees reviewing the subject.


"Under the present system, in many circumstances a CME course will be held only if a commercial society is uncoerced to buy at it,"' said Robert Jackler, MD, the medical school's associate dean for CME. "While for-profit enterprises may from time to time engage in philanthropy, it should non be surprising that the core motivation of pharmaceutical and medical-device industries in supporting CME is to market their products and services.


"This leads to a CME curriculum which is, at least in part, designed to address market of necessity rather than being entirely focused upon improving functioning of practicing physicians," added Jackler, wHO is likewise the Edward C. and Amy H. Sewall Professor in Otorhinolaryngology and chair of rhinolaryngology. "Clearly it would be preferable for Stanford staff to design our CME curriculum alone based upon the needs of our learners as they seek to address the healthcare needs of their patients."


Stanford's medical school number one took up the issuing in 2007, when Pizzo appointed a 16-member undertaking force, comprised of a diverse radical of faculty and faculty, to regard future options for CME. In fiscal 2006-07, about 38 percent of the school's budget for CME, or $1.87 jillion, came from industry sources. Task effect members gathered detailed fiscal data, reviewed the literature, interviewed manufacture representatives and engaged in spirited debates.


"We all agreed it is inappropriate for diligence to influence content," aforesaid Harry Greenberg, MD, the school's older associate dean for inquiry and chair of the CME task force. He said the group sought to set whether companies who wished to supply CME funding could do so without controlling the content.


"If industry truly wants to enhance the education of clinicians, they should be given the opportunity to do so," Greenberg aforesaid. "But we wanted to create a situation in which they had no effect on the option of topics or their content. So we're happy to have industry support as long as it is provided without strings or expectations about the course content."


Any funds received will be channeled through the school's CME office, which will work with the faculty to determine how best to use the money to meet the needs of physician-learners. The new process "really brings control of CME curricula back to academic aesculapian centers," Greenberg said.


Jackler said the decision will dramatically variety the agency the medical school conducts its CME programs. Rather than organizing symposia at hotels or resorts, he said Stanford's offerings, which draw physicians from around the earth, will taste to make use of campus facilities. "One of my hopes is to make Stanford a destination so we can keep CME programs here, leverage the fantastic cultural attractions on campus," he aforesaid. He aforementioned the school may try funds from private foundations to help support the new CME approach.


The medical schoolhouse also plans to modernise the format of future programs, relying less upon traditional lectures and devising greater use of groundbreaking educational technologies. These include Stanford's well-known programs in simulated and immersive encyclopedism, as substantially as former technologies that will become available with the orifice of the Li Ka Shing Center for Learning and Knowledge in 2010. The new CME programme also testament place greater emphasis on identifying interventions that promote quality tutelage and health-outcomes improvements as opposed to the more traditional CME focus on knowledge attainment.


Pizzo aforesaid he hopes Stanford's new approach to physician education Department will attend as a model for other medical schools around the state.


"I think right at once industry is under a lot of pressure in its use of marketing for education. They're re-examining their role in CME as well," Pizzo said. "As we take this step, my hope is that other institutions volition start to follow suit. I imagine the climate will alteration dramatically to enforce that. If institutions do non take greater responsibility, on that point is going away to be a mandate, whether it's one that we lead up or unitary that is imposed, that frees up these intertwined interactions of academia and industry round medical educational activity."

Stanford University Medical Center integrates inquiry, medical education and patient care at its trey institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford. For more information, delight visit the Web land site of the medical center's Office of Communication & Public Affairs at hypertext transfer protocol://mednews.stanford University.edu.

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