How can ACCME hope to monitor these programs in all the different specialties of medicine with a staff of 12, most of who are not physicians? There are literally thousands of commercially-sponsored programs per year.
So the ACCME doesn’t have the resources to do its job? Maybe the appropriate response would be to advocate for more resources. A litmus test for CME of guilt by commercial association is unfair because it has a prejudicial effect. The bias inherent in such an approach is revealed in Dr. Carlat’s own statement (italics mine):
Yes, it’s true that lack of industry funding does not guarantee unbiased presentations. However, presence of such funding almost guarantees a lack of balance.
Dr. Carlat’s final paragraph concerning the promotion of complementary and alternative (CAM) medicine is interesting. I had linked to three CAM CME offerings as examples of pervasive bias, conflicts of interest and scientifically unsound content in “Pharma-free” programs. I didn’t elaborate because I thought the examples spoke for themselves. Dr. Carlat countered:
Interestingly, the three activities he cites as “concerning” are programs that would never receive industry funding.
Well, yes, of course. That was my point. Maybe I’m missing something. He went on:
They are all courses on integrative or complementary medicine, offered by UCLA, Yale, and NIH. Each covers the clinical evidence for these treatments using evidence-based teaching, but because these techniques have little commercial potential, doctors are poorly informed about them.
Is he giving these programs a free pass? For excellent discussions on what’s wrong with that type of offering I would point Dr. Carlat to these resources.