I guess I’m not alone in loving physician bloggers (for some of my favorites, check the list on the right): There’s an interesting article in the LA Times about the phenomenon. These personal glimpses into what docs and other healthcare providers really think about today’s healthcare issue–even, sometimes, continuing medical education–are both informative and interesting to read. Now, if there only were CME provider bloggers, my day would be complete! (If you know of any, please let me know.)

From the Medical Journal of Australia: Research integrity and pharmaceutical industry sponsorship. (Thanks to  Anne Taylor-Vaisey for the pointer.)

This dovetails so well with the current push in CME for team-based training: reverse mentoring, where a person higher in the hierarchy is taken under the wing of someone further down the ladder. The example in the article is at a pharmaceutical company:

Jan Shioji is one of them. As director of pharmaceutical firm AstraZeneca’s Dallas regional offices, she started a reverse mentorship program early this year. She did it because she spends most of her days in the office and in meetings, and she admits that she was out of touch with the people who worked for her, people who were representing the company in public.



Shioji and the other directors had been discussing how to attract, retain and develop talent. What it all came down to was if “we want to continue to build leadership, we need to reach out to folks in the field,” she said.

I could also envision this working with doctors being mentored by nurses, orderlies, and others who they probably don t look to for advice very often. I have a feeling that the docs would probably hate it, but it could be a great boon for patient care.

To receive a weekly update, e-mail Sue.

There’s a very interesting article in Slate.com called, Spin Doctors: How drug companies keep tabs on physicians. It takes you through how weekly prescriber reports are created, and how companies use these reports to learn what each doc in a specific territory prescribed, and how much of it.can show the names of the doctors in a rep’s territory and what each doctor prescribed and how much of it. Well worth a read, especially if you’re a physician.

A reader recently pointed me toward a few posts on the Health Care Renewal blog:

Media Reports on How Pharmaceutical Companies May Manipulate Information

Editorial Argues Against Softening NIH Conflict of Interest Rules

A Troubling Study of the Contracts Between Medical Schools and Corporate Research Sponsors

Wall Street Journal: Medical Editor Turns Activist On Drug Trials

Given all, this, how is it possible for CME providers to, as the ACCME now requires,  identify and resolve ALL conflicts of interest for a CME program? This reader says, “Based on what I have read over the past months, we are only scratching the surface at the CME level regarding the whole issue of providing quality, unbiased, balanced education. It’s kind of like decorating a burnt cake with pretty icing.”

I have to agree that, given the relatively widespread nature of the financial ties that could bind, this all just makes it that much harder to resolve conflicts. Or even identify them, especially in cases where it’s been institutionalized and an individual may not even know what all ties he or she has, much less those of a spouse or other family member.

How far do you have to go to get a truly unbiased activity?

According to the Seattle Times, physicians are being wooed by Wall Street as well as pharma. While this probably won’t have much impact on CME, I find it an, um, interesting trend. A snip:

About one in 10 American physicians have become paid consultants to Wall Street in the past few years, a practice that gives some investors an edge but can create legal and ethical problems for doctors, according to a study published yesterday in the Journal of the American Medical Association.



In the first academic study of its kind, written by Dr. Eric Topol of the Cleveland Clinic and Harvard professor Dr. David Blumenthal, the authors found about 75,000 expert clinicians and researchers now consult for hedge funds, stock analysts, venture capitalists or other sophisticated investors.




That’s up from 15,000 doctors who consulted in 2002, and fewer than 1,000 in 1996.

One more thing to ask during the disclosure process, I suppose.