APM Perspectives
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Physician Preferences and Attitudes RegardingIndustry Support of CME Programs
Paul S. Mueller, MD,
a
C. Christopher Hook, MD,
b
Scott C. Litin, MD
a
a
Division of General Internal Medicine, and
b
Division of Hematology, Mayo Clinic, Rochester, Minn.
Pharmaceutical and other health care-related companiesspend approximately $12 to $15 billion per year($8000-$15000 per year, per physician) on marketing.
One marketing approach used by many pharmaceuticalcompanies is to provide financial support of continuingmedical education (CME) programs.
In recent years,this support has increased. Ten years ago, 17% of CMEfunding came from industry; today, that number is40%.
Between 1992 and 2001, industry support of medical school-sponsored CME quintupled.
Organiza-tions that conduct CME programs claim that withoutfinancial support from industry, programs must rely onregistration fees, which, when combined with travelexpenses, would make the programs unaffordable formany participants.
Physicians attend CME programs for many reasons,including fulfilling state medical licensure require-ments, maintaining hospital privileges and specialtysociety memberships, and obtaining new knowledgeand skills.
Many physicians also regard CME coursesas their most valuable source for clinical information.
However, evidence suggests that CME programs spon-sored by industry not only may be more biased (in favorof the sponsoring companies’ products) than programsnot sponsored by industry
but also may influencephysicians’ professional behavior (eg, increased pre-scriptions of the sponsor’s medication).
These find-ings raise the ethical concern of industry influence onphysicians who participate in CME programs.
CME PROGRAM SURVEY METHODS
Each year, Mayo Clinic College of Medicine School of CME (Rochester, Minn) conducts comprehensive inter-nal medicine CME courses, some of which receivefinancial support from industry. Over the years, direc-tors of these courses have received mixed feedback from participants regarding industry support. To betterunderstand physician preferences and attitudes regard-ing industry support of CME programs, an anonymoussurvey of physicians attending 4 Mayo Clinic internalmedicine CME courses was conducted in 2004. Phar-maceutical and other health care-related companies fi-nancially support 2 of the courses (Mayo Internal Med-icine Board Review and Mayo Clinical Reviews) withunrestricted grants and in accordance with Accredita-tion Council for Continuing Medical Education (AC-CME) guidelines. Financial support is given directly tothe course organizers and is used to defray the costs of the courses; the companies have no role in planning orconducting the courses. These courses allow industry-sponsored exhibits adjacent to the meeting room. Theother 2 courses (Mayo Selected Topics in Internal Med-icine and Mayo Practice of Internal Medicine) are notsupported by industry and have no exhibitors.Respondents completed the survey during a break period in the middle of each course. The one-pagesurvey instrument asked participants their age, sex, andyears in practice. The survey also included 4 specificquestions regarding industry support of CME activities.The results of the survey comprise the data set of thisstudy.Between-group responses to questions were com-pared using the Pearson chi-squared test. Ordinal logis-tic regression was used to fit multivariate models. Theresponse ordering was “yes,” “no,” and “no preference”
Requests for reprints should be addressed to Paul S. Mueller, MD,Division of General Internal Medicine, Mayo Clinic, 200 First StreetSW, Rochester, MN 55905.E-mail address: mueller.pauls@mayo.edu
A P MP e r s p e c t i v e s
0002-9343/$ -see front matter © 2007 The Association of Professors of Medicine. All rights reserved.doi:10.1016/j.amjmed.2006.12.009
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