Physicians today learn in two distinct ways. The first is through a curriculum set by medical schools and post-graduate training programs, or residencies. The second is through conferences and certification programs. Both methods of learning should be the same. They’re not. And that’s a problem.
Medical schools are regulated by the American Association of Medical Colleges. Medical students take standardized tests overseen by the United States Medical Licensing Examination. Sure schools may vary by size and location, but the curriculum is the same.
Medical conferences, on the other hand, are all over the place. Some conferences are held in resorts where physicians spend more time nursing hangovers than attending lectures. It’s a veritable vacation looking for a conference. Usually it’s some organization structured as a public-private partnership hosting a conference somewhere in Scottsdale or San Diego. The speakers are physicians or administrators with heavy industry ties.
Depending on the conference, and the organization backing it, you have different industry sponsors. Each sponsor has its cadre of physicians who come with preloaded presentations that are template-talking-points designed on behalf of the sponsors. Since these conferences are designed to facilitate physician learning, the presentations ostensibly determine what is taught. As a result, the medical industry dictates how physicians learn.
The medical industry might strive to promote good medicine and to improve the quality of care for patients through their devices and medications, but their intentions are anything but altruistic. The medical industry consists of private companies with a fiduciary duty to their shareholders. They’re decidedly conflicted in what they promote. There’s no combination of profit and patients that leads to a truly objective, educational forum.
So what’s taught is biased by industry influence. To a certain degree, it’s inevitable. Macro forces have always held sway in medicine. Insurance companies, whether they’re government entities or private corporations masquerading as nonprofits, design reimbursement models for physicians, which set the context for how care is administered. You could argue all of medicine is influenced by some outside entity in some way or another. But influence is a funny thing.
Influencing someone who understands they’re being influenced is different from influencing someone who is unaware of what’s going on. Education, comprising the act of learning, is a particularly vulnerable time for people. It’s when their minds are most receptive to information without much pushback. When physicians attend medical conferences to learn, industry folks and other entities with their own bias should have limited input in what’s being taught.
We all know this. But we accept it because of its pervasiveness. We see it as an acceptable evil rife with conflicts, but we’re too ingrained to do anything about it. So we leave it be. Medical schools determine what physicians learn at the beginning of their careers. The medical industry decides what they learn for the rest of it.
There’s an easy fix to this. Restrict the organization and administration of these conferences to accredited medical societies. They exist to standardize clinical care and advance specialty specific guidelines. They accredit physicians with board certifications. Most of them have disclosure requirements and are monitored by oversight agencies. They would be the ideal organizations to host medical conferences. It makes perfect sense. These societies set clinical guidelines, so they should also educate physicians on how to implement them.
This would standardize the curriculum per specialty across different conferences because one academic body would oversee it all. Sure industry would still be around, sponsoring exhibits and placing advertisements, but they wouldn’t direct the educational sessions. Their influence would be restricted to areas where physicians know they’re being influenced. That’s the key. Monitor when and where physicians are being influenced and make them aware of it. Ironically enough, that’s also part of the learning process.
