More than half of optometrists (51%) think that industry-sponsored continuing education is biased, according to a Review of Optometry poll.

To erase that kind of bias, representatives from optometric organizations and ophthalmic companies came together for a brainstorming meeting in late January to draft a set of guidelines on optometric CE, specifically about issues of industry support, speaker disclosure of corporate affiliation, and advertising.

No one wants to sit down at a CE meeting only to find out its an infomercial, says Paul C. Ajamian, O.D., general chairman of the CE Committee for SECO International and chair of the newly formed steering committee. No one should want that. Attendees certainly dont want that. And it doesnt make the meeting or the company providing the grant look good.

Called the National Steering Committee on Optometric Guidelines for Educational Support (NSCOGES), the group consists of representatives from the American Academy of Optometry (AAO), the American Optometric Association (AOA), the Association of Regulatory Boards in Optometry (ARBO), the Association of Schools and Colleges of Optometry (ASCO), SECO International, and several eye-care companies.

Optometry isnt the only discipline to address this issue. In 2008, the Accreditation Council for Continuing Medical Education (ACCME) released a set of quality standards for continuing education for M.D.s. Meanwhile, beginning January 1, 2009, the pharmaceutical industry adopted a self-imposed (and voluntary) ban on promotional materials and free meals for doctors, as well as a separation between marketing efforts and educational grants.

But, the separation of church and state doesnt mean that eye-care companies will no longer sponsor educational meetings. Thats the furthest thing from the truth, Dr. Ajamian says. The only thing changing is that companies will find different ways to give grants for unbiased educationwhich is what everyone wants, after all.

In other words, the free lunches are history. Yet, support for education will remain.

We wont be distributing any more tchotchkes and giveaways, says Dave Sattler, Alcons director of professional relations. The logo pens, the sticky pads and all the ancillary things that show up for the doctors and staff are pass. But, Alcons financial support for education at most meetings will remain strong, he says.

Representatives from other companies say the same. Our goal has always been to ensure that professional education is free from commercial influence, says Paul Lawrance, vice president of Health Care Compliance, Johnson & Johnson Vision Care. We will still be fully committed to the profession through our financial support of education.

The only meetings that might be affected are the smallest onesthose in which the company acted as the meeting organizer. Now, its a conflict of interest if a company is the administrator of its own meeting, Mr. Sattler says. Instead, a company that chooses to abide by the guidelines will have to hire an independent firm or organization to run the meeting.

For its part, NSCOGES plans to reconvene during SECO 2009 to establish policies on industry support and disclosure. (The committee is asking for your input. E-mail your comments to

This committee and other similar efforts are part of a groundswell of interestfrom both inside and outside of health carein disclosing financial arrangements between industry and doctors.

In late January, Senators Chuck Grassley (R-Iowa) and Herb Kohl (D-Wisc.) introduced legislationthe Physician Payments Sunshine Act of 2009 (S.301)that would require pharmaceutical, medical device and biologic companies to publicly report money or gifts that they give to doctors. Payments would be posted online in a user-friendly way for public oversight.

The goal of our legislation is to lay it all out, make the information available for everyone to see, and let people make their own judgments about what the relationships mean or dont mean, Sen. Grassley says. If somethings wrong, then exposure will help to correct it.

But, would such legislation hit the target yet miss the mark? The reason behind transparency and other such measures had started with controlling health-care costs. But, when you put all these tracking mechanisms and some of these guidelines in place, theyre actually costing us more money, Mr. Sattler says. So, in essence, have we really accomplished the job that were trying to do?

Vol. No: 146:02Issue: 2/15/2009