End the scandal of free medical education

I am writing in response to the views of Dr Spence and Dr Oliver with regard to interaction of commercial medical product companies with doctors via sponsrayere to avoid involvement of drug companies and therapeutic devices, I feel some of their assertions were built on false premise.

I have no doubt that most doctors attending sponsored meetings or spending time with reps discussing use of specific products are fully aware of the possibility (and probability) of marketing spin involved in these educational activities. While I acknowledge that there will be some naïve colleagues who may not be aware this, to paint the whole cohort with the same tar underestimates the capacity of our profession to use discretion.

Their idea that some medical education is considered ‘free’ because they are sponsored by commercial companies suggested our time spent on these activities are free. I am sure that most if not all doctors would have squeezed in rep talks in their limited meal breaks time and meetings in the nights or weekends not on call, or even taken annual leave to attend some courses and conference sponsored by companies. Surely many of us would have preferred to do something with our personal time on or individual pursuits or with family and friends rather than being tied up by work-related activities. To suggest the time spent on any form of educational activities does not occur at personal cost, devalues our colleagues’ worth overall.

And to paraphrase a Yes Prime Minister quote by Hacker: “Just because I attended a Russian embassy dinner, doesn’t make me a Russian spy”. The perceived conflict of interest from accepting small value items like pens and meals have been blown out of proportion. Surely in the corruptible few among us they had more pride than to be swayed by a $1.38 pen or a 50 pound Chinese meal. The few strayers in our professions would not be looking for small change anyway and would probably be active seekers of benefit rather than passive accepters of gifts. (We are not some Australian state politicians who make policies and decisions while being wined and dined by commercial entities). I see that the current level of declaration of interests for authors of opinions and papers is satisfactory.

I am perplexed by their push for exclusion of sponsors in conference and conventions. These meetings are not cheap and certainly commercial support contribute greatly to the success of any large conference (you can always tell when a n activity is run on the smell of any oily rag). As much as these commercial entities may contribute to the general fund of the meeting, few committees would actually allow these companies to dictate the content of the activities. I am aware of more commercial influence over newspaper and TV editorials and content than professional meetings, that does not stop most of us from reading newspaper or watching TV! (and please do not pretend that how much we pay for newspapers and TV licence would ensure independence from advertisers)

We need commercial resources in the medical world: we don’t use generic drug or hip replacements; the entity who makes them is always a commercial company. To avoid contact with them will delay the responsiveness of the companies to address problems and needs of the health care system. As long as we are aware of the pitfalls and each of us have a moral line we don’t cross, there is no need for a blanket ban on commercial sponsored education activities.