SACME session

Poor Bob Kristofco with the University of Alabama School of Medicine had a tough row to hoe at the SACME fall meeting Nov. 6 in Boston. He not only had the last session after a very long day, but he also had one of the hottest hot topics to deal with the new ACCME Standards for Commercial Support s conflict of interest brouhaha. While it s a much bigger issue for specialty societies than for academic providers, it still caused a lively exchange as Kristofco asked people how they were coping with it. Here's some of what they had to say.

One participant said he was relieved not to have to be the one to break the news to the specialty societies he works with, because they already knew about it. Another said she mostly heard from her own staff, who were "freaking out" about it. "We are going to look at this in a systematic way," she said. "It s unclear how the variation between different providers and how they resolve conflicts will affect faculty. We ve already had people come back to us and say that the specialty societies don t have a problem with" the way the speaker handles it. Another said, "A lot of people are saying that they just won t do accredited CME anymore."

Another participant didn t think it would be a big issue for her. "Look at the disclosure forms for the past year and see how many conflicts there are that you would have had to deal with. Is it really as big a problem as we make it out to be?"

Several participants said that they were developing ad hoc committees to deal with COI.

Another replied that it all depends on the level of conflict that exists. "The risk is for biasing a CME activity. Is the person a consultant versus a speakers bureau versus someone who s done research for only one company." Someone else added, "We have a policy that a conflict exists if the financial relationship is more than $10,000, the investigator or family member has to submit a COI form to us, and we resolve it."

Kristofco said that a lot of the issue revolves around content validation, which has "kind of gotten lost in COI." "CME units themselves have a significant COI," said another participant. "There are a lot of parallels to the IRB. I think we need to struggle with that for a bit."

And the last word was: "It s ironic that the exact same physician who can t speak to docs can go in and talk to medical students who are less equipped to determine bias than practicing physicians."

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