The agenda for continuing medical education--limiting industry's influence.

Most physicians must complete accredited continuing medical education (CME) programs to maintain their medical licenses, hospital privileges, and specialty board certifications. Data from the Accreditation Council for Continuing Medical Education (ACCME) show that CME is a $2 billion per year business in the United States that earns less than half its revenue from physician learners themselves.1 CME is increasingly underwritten by commercial sponsors — primarily manufacturers of drugs, biologic therapies, or medical devices — that spend more than $1 billion per year in educational grants and other funding to cover more than half the costs for CME activities.1 Industry funding of accredited CME increased by more than 300% between 1998 and 2007.1 Since the marketing goals of pharmaceutical and device companies can influence CME funding, preservation of the academic integrity of CME requires clear boundaries separating education and marketing. In 2007, there were 736 ACCME-accredited CME providers, including 270 physician membership organizations, 150 for-profit medical-education and communication companies, 123 medical schools, 93 hospitals and health care systems, 38 other nonprofit organizations, 15 government entities, 14 insurance and managed-care companies, and 33 providers that were not classified.1 Medical-education and communication companies sponsor more than 30,000 CME activities each year and receive more than half a billion dollars in commercial funding.1 The ACCME allows accredited CME providers to accept industry funding, but it imposes “Standards for Commercial Support” designed to temper potential industry influence.2 The ACCME’s standards require CME providers to identify CME needs and set program content that is “free of the control of a commercial interest.”2 In practice, however, CME providers can easily pitch topics designed to attract commercial sponsors, and commercial sponsors can preferentially award grants to programs that complement the marketing strategies of manufacturers. The Institute of Medicine noted that “CME has become far too reliant on industry funding and that such funding tends to promote a narrow focus on products and to neglect the provision of a broader education on alternative strategies for managing health conditions and other important issues, such as communication and prevention.”3