Cardiovascular Business - November/December 2008 - (Page 14)

“I believe strongly that placing outside limits on who speaks at Cme meetings can only compromise our ability as professionals to make decisions for ourselves.” Barry T. Katzen, MD, founder and medical director of Baptist Cardiac & Vascular Institute, Miami, Fla. Second, a decline in both grant support and attendance would force many well-regarded meetings to severely scale back or simply close up shop. The available choices for national CME would dwindle to a precious few, and the paramount goal of physician education for the good of the patient—the raison d’être of CME—would be compromised. Third, and perhaps most disturbing, the very conflict of interest that the current and forthcoming guidelines governing industry/physician relations seek to minimize would grow tenfold. Monies that manufacturers today dedicate to the support of accredited meetings—those that can be called CME because they adhere to the rules set forth by the Accreditation Council for Continuing Medical Education (ACCME)—would simply go toward marketing. Ironically, this creates a situation similar to the one that prompted the formation of the ACCME in the first place: Industry invites physicians to its own (non-accredited) meetings, to be wined and dined and learn only about a specific company product. This scenario of precipitously reduced industry support of CME is not hypothetical; it is already reality. Current and forthcoming guidelines set by the ACCME, trade industry groups that lobby for the pharmaceutical and device industries, and companies themselves (through formal regulatory/compliance departments), as well as, potentially, the government, have and will continue to exert a dampening effect on funding. Many of these responses are prompted by government actions against perceived abuses, many of which have nothing to do with CME but, rather, with marketing-driven activities. Beyond the negative impact on funding, however, changes enacted by the ACCME to guard against conflict of interest are affecting the quality of meetings. Course directors, in preparing programs for meetings, for example, are no longer allowed to discuss content with industry. On its face, this seems like a valid way to thwart undue bias. In reality, however, such conversations have until now provided an opportunity to learn about the latest promising research and to invite physicians involved in early trials to speak on their findings. And more changes are on the horizon, potentially forced by any of the entities mentioned above, all of whom fear the worst (in this age of desire for healthcare reform) and so insist on the most conservative route. One suggestion that has been made would prohibit doctors involved in trials from presenting results at meetings because of concerns that they may have been swayed to a positive opinion by payments made in exchange for their participation. In simplest terms, the very individuals who know the most about a new drug or device could be prohibited from sharing their expertise with colleagues in a formal, live capacity. Who, then, should we expect to talk about the findings, and how late in the game will we in the field hear about developments if those working on them must stay mum? What is our responsibility? As the course director for ISET, I take very seriously the role of managing potential conflicts of interest, an active process that requires good judgment and a shot of skepticism. I believe strongly that placing outside limits on who speaks at CME meetings can only compromise our ability as professionals to make decisions for ourselves. While not always perfect, national CME meetings provide an opportunity for broad exposure where debate flourishes, an occasion to dig beneath the perfect veneer that manufacturers might otherwise put forward. Without question, testing a speaker in front of hundreds of doctors in an open forum offers the best chance we have to hear the unadulterated truth. For years a standard practice at CME meetings, speakers must disclose their relevant financial relationships in writing. From there, it is up to the scientific community in attendance, both individually and as a group, to judge the talks and weigh the presented information against any disclosed potential bias. We in the field have already experienced the downside of some of the over-regulation that has driven much of the device innovation outside of the U.S. The death of CME as we know it would only further erode our ability to acquire knowledge and, ultimately, to treat our patients. A town hall meeting on the subject of CME funding and regulation will take place as part of the upcoming ISET meeting, scheduled for January 18-22, 2009, in Hollywood, Fla. The 21-year-old ISET meeting is a gathering for specialists working in vascular and cardiac intervention. To learn more, go to ISET.org. 14 Cardiovascular Business november/December 2008 http://www.ISET.org

Table of Contents Feed for the Digital Edition of Cardiovascular Business - November/December 2008

Cardiovascular Business - November/December 2008 Contents First Word Cover Story: Practice Management Software Moves Beyond Bean Counting The Death of CME as We Know It? Clinical Study Digets: Triple-Antiplatelet Therapy; Ex-Vioxx Users Beware Shockwaves Subside from the FDA's Echo Contract Warning Burning Question: Does Laser Heart Therapy for Angina Really Work? Advanced Visualization Adds New Practive Dimension Coronary Calcium Scoring Program Reaps Dividends Interventionalists Get Pumped Up About Mechanical Chest Compression Trials Force Physicians to Re-Examine Oral Anti-Diabetic Drug Protocols News & Views Calendar Reader Resources The ACC Corner

Cardiovascular Business - November/December 2008

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.