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Healthy Skepticism Library item: 19584

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Electronic Source

McNamara S
CPD: pharma should pay not sway
MJA InSight 2011 May 16
http://www.mjainsight.com.au/view?post=cpd-doctors-want-pharma-to-pay-but-not-sway&post_id=4574


Full text:

DOCTORS are concerned that pharmaceutical industry support for continuing professional development creates bias, but are not prepared to pay to reduce this influence, according to US research.

The study, published in Archives of Internal Medicine, of 770 US health professionals attending continuing medical education courses found that 88% believed commercial support introduced bias, but only 42% were willing to pay higher registration fees to decrease or eliminate this support. (1)

Professor Philip Mitchell, head of the school of psychiatry at the University of NSW, said the research captured the “central dilemma” of how to fund continuing medical education.

“It’s a really important issue. Doctors want their cake and to eat it too. They want less industry involvement but they’re not willing to pay for the consequences of that,” said Professor Mitchell, who has written on the topic of drug company influence, including in the MJA. (2)

Professor Jon Jureidini, a psychiatrist and spokesperson for Healthy Skepticism, said drug companies should not be involved in supporting medical education at all. Instead, doctors should pay for their own education.

“We doctors have to expect to pay for our education like everyone else. We also have to move away from the idea that we can only be educated in first-class hotels. It’s absurd when other professions are perfectly comfortable paying for their own education,” Professor Jureidini said.

Lawyers, for instance, generally undertake continuing professional development which is paid for by their firm, professional society, or by the lawyers themselves.

Professor Mitchell said that doctors did pay for some education, particularly through professional colleges, but removing commercial support entirely could increase the cost and reduce the availability of continuing education.

He agreed with the American research that many doctors would not be willing to pay higher fees for pharma-free education. The research found that health professionals greatly underestimated the costs of these events.

Medicines Australia said pharmaceutical companies had a valid role to play in medical education. “Nobody knows more about medicines than the people who spend years researching, discovering and developing them,” said Deborah Monk, Medicines Australia’s senior manager.

Professor Mitchell said the most important thing was to ensure that the educational content was developed independently of any commercial interests.

Professor Jureidini suggested that a blind, pooled funding model for medical education could be used, provided those who developed the educational content were unaware of specific funding sources.

“Pharmaceutical companies never really say that they provide education in order to sell their products, so if they want to make altruistic donations they could make those to a blind fund that could administer medical education,” he said.

In recent years, Australian regulation of commercially supported educational events has tightened. The details of all hospitality associated with these events are published on the Medicines Australia website. (3)

Earlier this month GlaxoSmithKline became the first Australian company to announce that it would publish the total fees paid to doctors for speaking and consulting services. (4)

Both psychiatrists agreed that this was a positive step towards greater transparency. “I think that’s excellent. It’s healthy because if people are doing the right thing they’ve got nothing to hide,” Professor Mitchell said.

He said he had not been a member of a pharmaceutical company advisory board since 2008 and had never owned stocks in pharmaceutical companies or received retainers.

Professor Jureidini said he had not received funding from drug companies.

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909