AMA Report (1): Industry Support of Professional Education in Medicine

The subject 1 Industry Support of Professional Education in Medicine is one of a series of 8 Reports of the Council of Ethical and Judicial Affairs (CEJA) of the American Medical Association. These reports have not yet been adopted as AMA policy; they will be discussed and debated in June 2008. If they receive the support of the majority of the delegates from the state and specialty societies, they will become policy. Anyone, including the general public, can provide testimony on CEJA reports either in person at the meeting or by writing to ceja@ama-assn.org.

I am presenting each Report as a separate thread on this blog. By clicking on the link above, you can gain access to the specific wording of the full Reports, 1 through 6 are to be Amendments to the Constitution and Bylaws of the American Medical Association. Reports 7 and 8 are for Informational purposes. (Note: An Executive Summary of the Report is posted below.) Why should the public be interested in these reports? They are part of the ethics of the system of medicine in the United States and may be reflected elsewhere in the world. Through the practice of medicine by all physicians, the rules presented in these reports can be applied to and may affect all patients. You may write directly your comments to CEJA at the e-mail address above and, of course, you are certainly welcome to post your comments on this particular Report here.

EXECUTIVE SUMMARY

Objective: To provide ethical guidance for physicians and the profession with respect to industry support for professional education in medicine.

Methods: Literature review; ethical analysis of issues in professionalism raised by industry support for undergraduate, graduate, and continuing medical education; and feedback from key stakeholders within the AMA.

Results: Medicine’s autonomy and authority to regulate itself depends on its ability to ensure that current and future generations of physicians acquire, maintain, and apply the values, knowledge, skills, and judgment essential for quality patient care. To fulfill this obligation, medicine must ensure that the values and core commitments of the profession protect the integrity of professional education. It must strive to deliver scientifically objective and clinically relevant information to individuals across the learning continuum. To promote continued innovation and improvement in patient care, medicine must sustain ongoing, productive relationships with the pharmaceutical, biotechnology, and medical device companies. However, industry support of professional education has raised concerns that threaten the integrity of medicine’s educational function.

Conclusions: Existing mechanisms to manage potential conflicts and influences are not sufficient to address these concerns. Recognizing the profession-defining importance for medicine of achieving its educational goals, the Council recommends that:

• Individual physicians and institutions of medicine, such as medical schools, teaching hospitals, and professional organizations (including state and medical specialty societies) must not accept industry funding to support professional education activities. Exception should be made for technical training when new diagnostic or therapeutic devices and techniques are introduced. Once expertise in the use of previously new devices has developed within the professional community, continuing industry involvement in educating practitioners is no longer warranted.

• Medical schools and teaching hospitals are learning environments for future physicians at a critical, formative phase in their careers and have special responsibilities to create and foster learning and work environments that instill professional values, norms, and expectations. They must limit, to the greatest extent possible, industry marketing and promotional activities on their campuses. They have a further responsibility to educate trainees about how to interact with industry and their representatives, especially if and when trainees choose to engage industry in varying capacities after residency and fellowship training.

• The medical profession must work together to identify the most effective modes of instruction and evaluation for physician learners. It must then more efficiently develop and disseminate educational programming that serves the educational needs of all physicians. The profession must obtain more noncommercial funding of professional education activities.

So the issue is what is the role of industry, if any, in medical education and should medical educators and physicians be advised to keep any such relationship to a minimum including funding and promotions. ..Maurice.