Continuing Medical Education in Diabetes: The Impending Crisis

A major health professional association sent an invitation to an upcoming continuing medical education (CME) program on a topic in metabolic disease. The invitation stated that the program was about the use of a specific drug for this disease state. The program not only was going to feature a speaker who was a paid advocate for that drug, but it also was scheduled to occur at the offices of the manufacturer of that product!

A recent editorial by Dr. Arnold Relman, former editor of the New England Journal of Medicine, bemoaned the corruption of the process of postgraduate CME by the influence of major pharmaceutical companies.¹ One of the published letters to the editor responding to this editorial criticized Dr. Relman's stance by noting that, while he was editor of the New England Journal, pharmaceutical company advertising and donations constituted a large percentage of the revenue of that publication.²

These examples serve to illustrate the growing quandary regarding the structure and function of CME in the United States today. Although there is a stated desire on the part of most health organizations and professional groups to distance program content and function from the influence of pharmaceutical companies,^3,4 this goal has proven exceptionally difficult. Medical professional organizations are highly dependent on the financial support drug companies and other vendors provide to educational functions. Pharmaceutical companies want those educational experiences to be supportive of their specific market position. And, given the potential for corruption in that dynamic, outside agencies are becoming increasingly involved in the regulation of this process.

These issues are very important in diabetes care. As a disease state, diabetes and related metabolic disorders are the subject of increasing focus for pharmaceutical companies. More and more drugs are being introduced or investigated for …