Author: Sean McCarthy
One of the best tools in the sales reps’ bag is the physician training course brochure, right? Send a surgeon to a course on the latest technique for valve surgery or minimally invasive approaches. Along the way the physician is taught by another surgeon, a colleague, the proper techniques on how to use the technology. While there, they cross-pollinate with other attendees on new tips and techniques while likely enduring a little company marketing along the way. The result, usually, is that the surgeon returns to do the procedure in the typical “see one, do one, teach one” routine that is commonplace and uses your new device resulting in new revenues for the company. Said company now invests some of these revenues into new products with the help of many of the same surgeons that teach or attend the courses and the cycle repeats thus allowing the patient to continually benefit from the latest advances. It is a nice synergy and seemingly everyone benefits.
Well, don’t look now but regulators are looking for conflicts of interest (and I am not saying they don’t exist in certain circumstances). Sometimes the relationship has crossed the line and physicians may spend too much time working only with one company exclusively implanting their device and making large sums of money for speaking and/or teaching engagements while other techniques may be ignored. However, I feel this is more the exception today rather than the rule, and regulators have brought most of these suspect relationships to light. Today, most surgeons I know work with multiple companies and are conscientiously more transparent in their relationships. If some regulators get their way, we may shift to an extreme of removing all company involvement in education via grants to CME courses or direct sponsorship.
There has to be a middle ground. If not, who pays the bill to develop, market and send physicians to these courses? Perhaps the physician or hospital will be forced to but we all know this will be difficult. How does a physician or other healthcare professional (HCP) learn to use the new device? You sell a new device, and a surgeon wants to go to a course to learn how to safely and most effectively use and apply this device, but industry cannot pay for them to go or your company can’t even provide training?
The CME debate is raging. As a consequence, CME-accredited courses and funding are dropping as the flow of grant money and support from industry slows. Additionally, CME courses may not be offered because funding sources aren’t available for such a narrow focus as a new device or procedure. The regularly-occurring weekend labs in the 1980s and 1990s helped general surgeons learn lap choly–a with tremendous patient benefit–would now be a conflict of interest because medical device sales reps were showing them how. If a hospital buys a multimillion dollar robot, who trains the entire staff, physicians and HCPs, in the hospital on their very own equipment? If someone from the medical device industry trains surgeons, it could be construed as a conflict or worse–a lawsuit. Want to sell a new valve or a new medical anything? Better hope your surgeon goes to an accredited CME course with no industry sponsorship and complete transparency from the educators so that there is no perception of bias. And, surgeons have plenty of time to go to those courses because they would rather take time away from their income-producing activities, right?
Well, recently a major device manufacturer was hauled into court alongside their surgeon when a procedure went wrong. This medical device company was accused of wrongdoing because they offer training to the surgeon. How long until the companies say no more and stop offering courses themselves? Who will fill this void? There is a fine line between too much regulation and not enough.
- Debate over Industry Role in Educating Doctors (nytimes.com)
- Commercially funded CME programs and whether bias can be removed (kevinmd.com)
- Digital firm creates the remedy to medical sales spin (prweb.com)
- Advocacy Efforts Supporting Industry Collaboration in CME (medicineandtechnology.com)
- Teaching Medical Robots (usnews.com)