Big Pharma ‘fills void’ for doctors’ college
Report suggests ways to curb influence
The agency that certifies Canada’s f amily doctors says it will keep t aking drug- i ndustry money to pay for its education programs despite commissioning a report on Big Pharma’s influence, which it then kept under wraps for two years.
One critic called the response from the College of Family Physicians of Canada after putting so much time and energy into the issue “embarrassing,” while the college itself says lack of taxpayer aid leaves it with few options.
“This is a funding vacuum that the pharmaceutical industry has filled for most f amily physicians’ practice lifetimes,” college leaders write on the website, healthydebate. ca. “In the absence of public funding, the private sector filled the void. This is not a ( college) decision but a reality with which we live.”
The newly divulged report — completed in 2013 — makes modest recommendations to curb industry’s impact. They include making conflicts of interest more transparent, setting up a new, independent fund for continuing education that won’t be linked to specific sponsors, and letting doctors get their meals at college conferences without running the gauntlet of industry marketing booths.
But the college is stopping well short of turning off the flow of pharmaceutical money — and still refuses to divulge an analysis of exactly how much corporate funding its educational programs receive.
College leaders were not available for comment Monday.
Numerous studies have suggested that physician prescribing habits are adversely affected when pharmaceutical money is behind their education, which they are required to continually update.
One longtime critic of industry’s relations with doctors says the college should simply have said no to industry funding, and required doctors to pay the whole cost of their conferences and seminars.
That’s what other professions — from accounting to law — already do, said Alan Cassels, a researcher at the University of Victoria.
“I think this should be a fairly serious source of embarrassment for the college,” he said. “Why should physicians require an obviously biased third- party to fund their continuing education? … These are the most wellpaid professionals in the country, definitely in the top 10 per cent, and they can’t fund their own education? Come on.”
The college deserves some credit for at least tackling the question of its ties with for- profit players; few similar medical organizations in Canada have done so.
The report on industry influence was submitted to the group’s board in November 2013, but was released publicly late last month only after a challenge from three doctors on the healthydebate site.
Some of what is recommended is valuable, but the organization could have been much tougher, argues Dr. Joel Lexchin, who co- authored the editorial taking the college to task.
He cited a family-medicine group in Oregon that has eschewed industry funding entirely, and an emergencymedicine journal in Australia that declines all drug- company ads.
“This report took over two years to become public,” added Lexchin, a Toronto emergency doctor and health- policy professor at York University. “That doesn’t strike me as a demonstration of a leadership that is willing to get out in front of this.”
The college plays a key role in Canadian medicine, accrediting the medical schools that train family doctors, certifying the generalist physicians themselves and overseeing continuing medical education for 35,000 working family doctors. It also publishes a widely read journal.
Dr. Jennifer Hall, the president, and Dr. Fancine Lemire, its executive director, say they are committed to addressing the issue. The unrestricted medical-education fund — to which companies and others could contribute — is under development, and the college’s annual conference is making it easier for doctors to avoid the industry exhibitors’ hall, the physicians note.
But they said it’s important to understand that “private sponsorship is currently the primary means of support for most continuing professional development offered to Canadian physicians.”
Sergio Sismondo, a Queen’s University professor who studies interactions between doctors and drug companies, echoed calls for the college — and other medical groups — to shut off the industry pipeline completely.
The line between straight marketing and continuing education is often blurry, with the same industry-paid experts often doing both kinds of presentation, sometimes with identical sets of slides, he said.
The college also commissioned an analysis showing the impact of eliminating industry funds, to be completed by November 2014.
But it has yet to be “finalized” and won’t be made public for now, said Jayne Johnston, a college spokeswoman.
THEY CAN’T FUND THEIR OWN EDUCATION? COME ON.