*From the Medical College of Wisconsin, Milwaukee, WI.
Correspondence to: Basil Varkey, MD, FCCP, Professor of Medicine, VA Medical Center/CC 111E, Milwaukee, WI 53295
the midst of many intellectually and personally satisfying experiences
at the recent CHEST 2000, I found a couple of things that concerned me.
Here I write about them—name tag and satellite symposia—with no
malice and with considerable affection to the American College of Chest
Physicians, an organization that I have belonged to for a long time.
The name tag, this time around, was designed as a neck ornament with no
clip or pin and it very prominently displayed commercial drug names. I
was both dismayed and disappointed at its implications for our
organization and for our profession. The provision of this tag in the
registration packet implies sanction of this type of advertising by the
organization. Are we to be walking billboards for pharmaceutical
Some may ask, are we not already accepting gifts and lending
ourselves to advertisement when we carry bags, pens, and other items
with drug company logos? Yes, we are, and we should reflect on our
values and our patient’s perceptions1–2 and define the
boundaries of our relationship with the pharmaceutical industry. But
advertising on our chests while we attend the international meeting of
a prestigious professional organization goes way beyond the boundary.
Surely the pharmaceutical companies have the right to advertise and
market their products and to expect appropriate space, time, and forum
for these activities in meetings that are financially supported by
them. But that does not include our chests!
The exhibit halls are the proper places for promoting the devices and
products of industry, and by confining these activities to the exhibit
halls, a separation between the commercial parts of the meeting and
intellectual/professional growth parts can be made. Satellite symposia
blur this line of separation. Satellite symposia are considered a
needed trade-off that professional societies must make so that the
annual scientific meetings are less expensive and therefore more
attractive for members to attend. Should it be so, and should there a
limit to the number of satellite symposia?
The number of industry-sponsored satellite symposia and the time
allotted to them at CHEST 2000 appeared to be at an all-time high. Each
of these symposia, sponsored by a single pharmaceutical company,
clearly has a commercially driven agenda. These agendas, when allowed
expression under cover of professional organizations and their
associated meetings, introduce an identity bias. A recent editorial in
Lancet addressed this issue and noted that elimination of
identity bias depends on organizations recognizing that their public
reputation rests on independence, and once given up, that independence
will be impossible to reclaim.3 The editorial also
suggested that organizers carefully review the content and limit the
proportion of meeting content that is allotted to industry-sponsored
The influence of industry sponsorship on medical education—content,
objectivity, and outcome measures—has not been scrutinized to the same
degree as sponsored clinical research.4–6 The magnitude
of industry-sponsored medical education is revealed in a survey of
private businesses that are medical education service suppliers. These
suppliers in 1998 and 1999 billed the pharmaceutical industry $353
million for grand rounds, symposia, publications, and advisory
boards.7 The billed amount for symposia alone was in
excess of $100 million. Studies of the content of published sponsored
symposia reveal that they have promotional attributes, and alert the
readers to approach these symposia with skepticism.4,8
Should we not be less dependent on drug company subsidy for our
continuing medical education?
Each year at the convocation ceremony, we recognize and welcome new
fellows to our College. Many young physicians in training attend and
present their work at the annual meeting. What messages are we giving
them? It is time for introspection. Our thoughts and ideas on our
profession, its integrity, and boundaries of behavior must shape the
future of our College.
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