Stanford School of Medicine recently received a $3 million grant to eliminate corporate influence on continuing medical education (CME). The grant, however, came from an unexpected source: pharmaceutical giant Pfizer, Inc.
Since 2008, Stanford has had a strict policy against commercial support for specific CME programming. However, this grant is an exception due to its open-ended scope. The three-year grant will go toward a new metric-based approach to the overall Stanford CME program and will be distributed at Stanford’s discretion, without any input from Pfizer.
“The grant comes to us as a gift, and Pfizer will not be involved in how it is spent,” wrote Medical School Dean Philip Pizzo in an e-mail to The Daily.
CME consists of seminars and classes for practicing physicians to update them on advances in medicine. Doctors must attend CME at regular intervals to keep their medical license.
The new CME program Stanford seeks to implement bases its curriculum off of data on how doctors perform. Using a wealth of data sets on the subject, the CME team at Stanford have found specific subject areas where doctors at Stanford need improvement. These subjects include smoking cessation, preventing surgical infection and reducing readmission for heart failure.
Pfizer will be giving Stanford $1 million each year from 2010 through 2012.
According to Robert Jackler, the associate dean for CME, there have long been problems with commercial influence on CME programs. “CME has been corrupted by the commercial system,” he said. “Many programs that are taught are biased…toward a commercial project.”
As Jackler explained, many classes are taught at tourist destinations and financed by corporate giants with huge commercial interests in the subjects being taught. These influences have affected the curricula both overtly and indirectly.
After Stanford adopted a strict policy of eliminating commercial interests, the University has been running programs without any of the lucrative corporate funding received by other schools.
“Since the time we adopted [our policy] in 2008, the companies never gave us anything, and we never even asked,” Jackler said.
Now, with the Pfizer money, Stanford seeks to create a new evidence-based curriculum for CME that redefines the programs free from industry influence. The major question, however, is why Pfizer would now offer Stanford such a large grant toward a curriculum that does not serve any of its corporate interests.
A Pfizer representative characterized the move as an act of patient service. “The grant to Stanford provides the opportunity for credible, publicly-transparent collaboration around areas of mutual patient-centric interest where it is understood we are here to serve rather than be served,” said Pfizer Media Director Kristen Neese.
However, Jackler put Pfizer’s decision into a larger context.
“Pfizer has been a bad actor. They just filed a 2.3 billion-dollar settlement with the Department of Justice…there’s no question Pfizer has been a sinner,” he said. “[Pfizer was] seeking to do it a different way, and I think they were seeking a partner who had a reputation for doing something with the highest ethics.”
Pfizer’s September settlement with the Department of Justice centered on fraudulent advertising charges for the drug Bextra, along with other products. The charges involved kickbacks to health care providers in an effort to encourage doctors to prescribe them, along with extensive off-label marketing.
The grant to Stanford may not offer Pfizer commercial marketing opportunities, but as Pizzo explained, it could help the company improve its public image.
“Virtually every pharmaceutical industry has served the public poorly with their CME programs,” Pizzo said. “And I would further add that physicians and institutions have been complicit as well. I have no doubts that both need improvement in their reputation, and I am sure that has figured into the Pfizer decision.”
Jackler concurred that image could be behind the grant, but he also hoped that Pfizer truly took an interest in better medical education.
“It would not surprise me, but my firmest hope…is that it’s not to polish their image,” he said.
Jackler said he believed that if CME is done the right way, it can help doctors keep up to date with scientific breakthroughs and to learn about the latest advances in the medical field. He said this could, in the end, benefit the industry as well as patients.
“If your company has really good products that meet those criteria, then it will work out for you in the end,” he said.
Jackler also cited the potential positive impact of the grant for the University. “Three million dollars in education is a huge grant. We can do some really good things at Stanford here with this,” he said. “We’re seeking to be a paradigm shift.”
Pizzo is optimistic about the program, but noted that it will be monitored closely. “I view this as an experiment,” he said. “We will have to see if this can be accomplished–and will be monitoring it very carefully.”