Current Psychiatry has been publishing a series of deceptive ads that appear to be patriotic calls for freedom of the press, but which in reality are stealth endorsements of industry-funded CME, paid for by drug companies and medical education companies.I've reproduced the ad to the left here, but you can read it in its full, large-fonted glory here.
"IN THE UNITED STATES," the ad begins, "THE PRESS CANNOT BE CENSORED. THE INTERNET CANNOT BE CENSORED. POLITICAL ADVERTISING CANNOT BE CENSORED." Here's the kicker: "WHY ARE SOME MEMBERS OF CONGRESS AND ACADEMIA TRYING TO CENSOR MEDICAL COMMUNICATIONS?"
Then there are a few paragraphs of gibberish stating that information is important for quality health care (that's true, that's why I went to medical school and keep up on the medical literature) and how "Congress and academia are seeking to restrict the content of CME" and how this somehow amounts to "restrictions on how much information consumers and doctors can know about current and new treatments...."
At the end, in small italicized print, we read: "This message is brought to you as a public service by the Coalition for Healthcare Communication."
To find out who is the "public" benefiting from their "service", surf on over to their website. It is simply a repository of political ammunition for medical education companies who are on their last ditch stand defending their business model, which depends on getting drug companies, rather than our doctors, to pay for CME.
I am hardly the first physician to be outraged by this stealth ad. Michael Herbert, a primary care doctor and blogger, posted this analysis of the ad that is so nicely written it became an "editor's pick" of OpenSalon magazine.
Entitling his article "The Secret Defense of CME," Dr. Herbert concludes his piece thusly:
"Unsurprisingly, this campaign underscores what is wrong with CME funding. You can’t tell where the money is coming from. This makes it difficult to interpret the message, or measure the bias. If Big Pharma and drug marketers can’t defend their CME practices without disguising them in cryptic constitutional arguments, it is hard to see them presenting CME in a way that would allow doctors to clearly evaluate bias.
This is not an ad for freedom of speech. It is an ad for secrecy. And secrecy in a scientific discipline is not a good thing."
Dr. Herbert saw this ad in American Family Physician, and I assume the thing has metastasized throughout the medical literature. I urge readers to write letters to their professional journals in protest of this sneaky screed. I know I will.
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7 comments:
File this under the 'can dish it out but not take it' department. I'm usually prone to agree with you, Danny, and appreciate your efforts to clean up CME - but this crosses the line. So the ad expresses an opinion you don't agree with (and frankly, one that many both in and out of academia *do* agree with). I'm not clear about what's offensive about expressing an opinion? If it's solely the attribution, it seems like you and others had no trouble discovering the sponsors behind the sponsor. Unless you're going to apply a different standard to ads critical of you versus most political ads (which use similarly bizarre and counterintuitive names - 'committee for sensible energy policy', and so forth) I daresay this qualifies as the same kind of free, if disagreeable, speech.
Instead of phony advertising, we need to hear what the Coalition for Healthcare Communication says about the corruptions of commercial CME by compromised academic KOLs. This is why groups from the Institute of Medicine to the Macy Foundation have recommended an end to corporate funding of CME. What kind of corruption? Oh, things like Alan Schatzberg pushing his company’s underperforming drug in a Lilly-sponsored CME program on depression. Or Charles Nemeroff pushing his corporate client Janssen’s drug Risperdal for depression, even though the report he “authored” was retracted. Or Zachary Stowe going beyond the scientific record in order to push AstraZeneca’s drug Seroquel for depression in a CME Outfitters program sponsored by AZ.
No, the Coalition will wave the flag and appeal to misguided patriotism/first amendment rights in order to distract attention from the shit that goes down every week in commercial CME.
Localdoc,
This ad is deceptive on two levels. First, the content is specious. The move to deprive industry-funded CME of accreditation is not "censorship," as the ad states. Key opinion leaders, drug companies, and MECCs remain free to publish any promotional speech they want, and doctors would be free to read it or listen to it. It simply would no longer receive a special seal of approval called "category 1 CME."
Second, the design of the ad is deceptive. It is presented as if it were a patriotic public service when in reality it is simply an effort to maintain the income stream of certain commercial enterprises.
If the ad had started out with something like: "A message to the medical community from the medical education industry" and then laid out a series of rational arguments in favor of industry-funded CME, I would have still disagreed with it but I would not have ridiculed it. That would have contributed to open debate.
The pharmaceutical industry only believes in freedom of speech when it's in their own interests.
For example FDA employees can be fired for saying anything publicly that would would suggest any inappropriate activities between the FDA and the pharmaceutical industy.
This is reflected in the following policy and procedures of the FDA Center for Drugs:
Which indicates
4641.3R Outside Activities (Revised 7/1/2008; Posted 8/8/2008
Outside activities including speaking, writing, or teaching are prohibited when they "create an adverse effect on the image of FDA."
This can be found in at the following site:
http://www.fda.gov/AboutFDA/CentersOffices/CDER/ManualofPoliciesProcedures/default.htm
Dr. Carlat-
I continue to be stupefied by your continued insistence on lumping privately-held, accredited CME providers with pharma as villains. The catalog of abuses summarized by Bernard Carroll would indicate to me that academic institutions are at least equally culpable. In fact, most of the major conflict of interest horror stories that have been coming out lately seem to be in the field of psychiatry. So why aren't you attacking academic psychiatry as the insidious party who is in bed with pharma?
Anon--You're off here. I'm an equal opportunity critic. If you go through my archives you'll see that most of my posts have focused on conflicts of interests among academics, especially in psychiatry.
You are right, however, that private MECCs are not the only "villains." The specialty medical societies have increasingly been at the forefront of defending industry funding of CME. In this regard, psychiatry has actually set a shining example.
Current Psychiatry's advertorial has prompted numerous comments, echoed in Dr. Herbert's conclusion: "If Big Pharma and drug marketers can’t defend their CME practices without disguising them in cryptic constitutional arguments, it is hard to see them presenting CME in a way that would allow doctors to clearly evaluate bias." What I don't see is any criticism of the journal itself for running the free ad to begin with. I wonder what the editors and the editorial advisory board would have to say about such a self-serving advertorial represented in the magazine as a "First Amendment" message? The publisher has a real credibility problem here!!!
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