CME Companies Tracking M.D.s’ Personal Information

Medical communication companies (MCCs) are doing more than offering online continuing medical education (CME) courses to physicians—the companies may be monitoring clinicians’ website behavior as well.

Researchers from the Mailman School of Public Health and the Center for the Study of Society and Medicine at Columbia University investigated the financial relationship between MCCs and drug companies and whether MCCs accurately represent themselves to clinicians using their CME offerings. They reported their findings in the December 18, 2013, Journal of the American Medical Association.

“Our center primarily focuses on conflicts of interests as they relate to pharmaceutical companies,” Shelia Rothman, Ph.D., lead study author and deputy director of the Center for the Study of Society and Medicine, told Psychiatric News. “We began with simply observing grant registries of these companies and wondered if they used biases in regard to awarding grants to certain individuals, health organizations, or academic institutions.”

Rothman and colleagues evaluated the grant-giving practices of 15 pharmaceutical and medical-device companies that provided a complete report—all four quarters—from Fiscal 2010. Some major industry names that were included were Bristol-Myers Squibb, Merck, and Forest Laboratories. The researchers reviewed more than 19,000 grants that were given to 6,493 recipients. The grantees were divided into multiple categories including MCCs, academic institutions and affiliated hospitals, and disease-targeted advocacy organizations.

Data showed that of the $657 million in grant money awarded by the drug and device companies, 26 percent was allocated to MCCs, followed by academic medical centers at 21 percent and disease-targeting advocacy organizations at 15 percent.

Eighteen MCCs received more than $2 million each in funding. Of those heavily funded MCCs, 99 percent offered free online CME courses, and approximately 60 percent of these companies acknowledged using cookies and Web beacons to track physicians’ online activity, in addition to sharing physicians’ personal information—such as demographics, professional specialty, and license number—with third parties including “educational partners” and companies with which they have a working relationship.

“Industry contracts with MCCs are not publicly available, which made it difficult to thoroughly investigate MCCs’ relationships to industry and to physicians,” Rothman told Psychiatric News. “I hope medical professionals began to explore what is going on with online CME training. Physicians should be able to feel that these [medical communication] organizations are acting in their best interest.”

According to the study authors, although MCCs did not elicit users’ explicit consent, the companies did interpret “participating in a CME course and navigating the [MCCs’] website as an implicit agreement to share information with third parties.”

Paul Appelbaum, M.D., a former APA president and the Dollard Professor of Psychiatry, Medicine, and Law at Columbia University College of Physicians and Surgeons, cautioned that “even ‘free’ CME courses come with a price.” He emphasized that information collected by MCCs may be shared with pharmaceutical companies for market research or targeted promotions, leading to physicians being visited by certain drug representatives.

Appelbaum, who currently serves as chair of APA’s Committee on Judicial Action, urged all clinicians to evaluate the privacy policies of the sponsoring companies before signing up for CME courses. “If physicians aren’t comfortable with the amount of information they will be revealing, they should decline to participate,” he said. ■

“Medical Communication Companies and Industry Grants” is posted at http://jama.jamanetwork.com/article.aspx?articleid=1790870.