The Medical–Industrial Complex and Conflict of Interest in Pain Education

Abstract

It has been widely accepted that high-quality continuing medical education (CME) is important in all areas of medical practice [1–4]. However, given the challenges inherent in the practice of pain medicine in the United States, the importance of accurate, timely, and unbiased CME in pain—not only for “pain specialists” but for all professionals who treat pain—has become an even greater imperative. Despite recent Institute of Medicine data suggesting that 116 million Americans suffer from chronic pain [5] and the frequency of pain as the precipitating reason for physician visits [6], there are presently only five states that mandate pain CME for their physicians. State medical associations, for the most part, have vigorously opposed mandatory CME in pain, suggesting an attitude of physician autonomy trumping pain patient well-being. While many practitioners claim that the potential industry-driven conflicts of interest do not impact the manner in which they practice [7–9], a considerable body of literature [7,10–12] strongly suggests that this is not the case. Additionally, conflicts of interest play a role in eroding patient trust in physicians [13,14], which has certainly become a salient issue in pain medicine, particularly in recent years [15–17]. It has also been noted that not only does industry spend enormous amounts of money in efforts to influence physician practice, but does so in a manner meant to convince physicians that this is not its actual intention [18]. When, for …