domingo, novembro 04, 2012

Conflitos de interesse, associações médicas e o que fez a NASS


Registro aqui iniciativa da North American Spine Society, descrita através de Conflict of interest and professional medical associations: the North American Spine Society experience, Spine J. 2012 Oct 23. Foram muito lúcidos, tranquilos e objetivos nas premissas e razões apresentadas:

 - In order for medicine to progress, some forms of relationships between physicians and industry are necessary. Although such relationships can be professional, ethical, and very worthwhile, they are conflicted by their very nature and have the potential to create unconscious bias that might influence patient care. The potential value of the relationship does not mitigate this effect.

- COIs of a PMA and its leaders can have a more far-reaching effect on patient care than those of an individual physician.

E partiram para o enfrentamento da questão:

- Over several years, NASS instituted steps to reduce the impact of financial dependence on industry. At the annual meeting and other CME conferences, NASS no longer licenses the rights for a company to use the company name or logo on promotional items, such as hotel key cards, lanyards, or tote bags.

- North American Spine Society neither sells permission for satellite symposia nor accepts funding for meals or snacks during breaks.

- The exhibit hall is separated from meeting rooms, and therefore attendees need not pass through the exhibit hall to reach education venues. As a result, an attendee may be present at an NASS conference without interacting with industry advertising or representatives if he or she so chooses.

Consequências para a corajosa associação médica:

- The finances of NASS have remained sound. In fact, the overall revenue has increased. Annual meeting registration fees and exhibit hall booth fees were increased modestly, and the meeting duration was shortened, which decreased the costs. Although membership dues were increased slightly, membership has increased, and there has been even better attendance at the annual meeting and other CME courses.

- There were no meaningful serious effects to the implementation of divestment and disclosure policies.


- In order for a PMA to maintain its integrity while fulfilling its mission and remaining financially solvent, it must work toward minimizing revenue from industry and maximizing revenue from sources that do not present conflict. Professional medical associations may need to increase dues to cover the costs of running the organization or increase membership recruitment efforts to make up for the loss.

- However, even in the current financial climate, NASS has shown that a PMA can manage its financial relationships with industry in a manner that minimizes influence and bias. The NASS experience has demonstrated that the fears of lost revenue and lost membership are not warranted. North American Spine Society is thriving today despite the risks taken to decrease its dependence on industry funding. The evaluations of our educational meetings have never been higher. The society is attracting larger number of members and in greater professional diversity. The NASS brand has become known for having speakers that speak from evidence, not bias. The same reputation for disclosure and divestment also permeates our health policy,coding, and advocacy efforts. We believe the NASS experience can serve as a model for other PMAs that are struggling with these important issues.

Muito legal!

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