One of the main goals of medical education should be to teach practitioners how to provide the safest, most effective, and least expensive treatments for their patients. In contrast, one of the main goals of pharmaceutical companies is to maximize profits for their shareholders by persuading physicians to prescribe more drugs, and particularly more high-priced drugs. Any medical education provided by or funded by the drug industry is, therefore, potentially tainted by conflicts of interest and should be viewed with caution. And to the extent that academic medicine allows drug money to sponsor medical education, it risks compromising the purported goal of teaching practitioners how to provide the safest, most effective, and least expensive treatments. It is therefore disconcerting to see how many different ways pharmaceutical money has infiltrated medical education. These include sponsorship of continuing medical education (CME) programs, hiring speakers to give grand round presentations at hospitals, and paying researchers or ghost writers to write review articles for medical journals.

Dr. Adriane Fugh-Berman, a professor at Georgetown University Medical Center, has researched and written extensively about how the drug industry influences medical education. In an essay published recently in BMJ, she argued that industry funding of CME causes doctors to have a distorted view of the risks and benefits of treatments and ultimately harms patients.¹ She pointed out that industry-sponsored CME tends to emphasize the benefits, while ignoring or minimizing the dangers of their products. In one study, for example, doctors were randomly assigned to read one of two papers on non-cancer pain: a clinical practice guidelines paper or a CME paper sponsored by the manufacturer of an opioid drug. When asked to summarize the article, physicians who read the practice guidelines paper concluded that there is not sufficient evidence to support the use of opioids for chronic non-cancer pain and that opioid use may lead to addiction and increase mortality. In contrast, those who read the industry-sponsored paper emphasized the benefits of opioids and mostly failed to mention the risk of addiction or other adverse effects. Another study found that industry-funded CME programs on binge-eating disorders recommended treatment with amphetamines but failed to mention that such treatment can cause addiction, myocardial infarction, stroke, and death. Sadly, physicians often seem to be unable to identify when they are being given biased information, and studies have shown that most physicians do not believe that industry-sponsored CME is biased.