Med Ed & Big Business: A Scary Relationship
Medscape and Diabetes UK put on trial...
We at Pareto have been in the medical education world for a few years.
I’ll be honest, our motivation as a pair (me & Kim) was purely because we love teaching. Ofcourse, we have to cover our costs but our policy has always been to try and increase access to our content to as many people as possible. In our time, we have been approached by personnel/companies to advertise their profiles but we have refused. For us, we want to keep our intentions pure and sincere.
Recently, both Medscape and Diabetes UK have been found to be involved in business deals that put their motivations into question.
A thorough investigation by the BMJ found that Medscape’s smoking cessation courses were developed and sponsored by the US tobacco giant PMI. The content itself was found to funnel practitioners to providing non-tobacco (but nicotine containing) products as a “safe, risk free” alternative to tobacco. These products were presented as harmless using relatively weak evidence. The potentially multi-million pound deal was eventually pulled but such curriculums have already been rolled out to practitioners around the world.
Meanwhile, on the other (right) side of the Atlantic, the UK charity Diabetes UK has announced a partnership with Slimming World. This has come under severe criticism due to Slimming Worlds unfortunate reputation of producing mislabelled products. Diabetes UK have defended this on the proviso that Slimming World is an expert in the area but it has ignored advice from doctors as well as its own advisory groups.
Big Business & Medicine
Tobacco and weight loss are huge industries. For example, the global weight loss industry is currently valued at 2296.41 million. Furthermore, the global tobacco industry is valued at USD 886.09 billion. These are huge figures and in order to keep their industries alive, there is a high degree of managing public opinion.
The challenge for us is that we encounter a number of treatment options either from patients or drug companies, and we are sometimes unable to decipher whether a treatment is effective or not. Of course, testimony is a valid source of knowledge so we trust institutions such as NICE but sometimes these institutions haven’t yet formulated their view.
I’m sure you’ve all sat in Pharma meetings where a drug representative comes to talk to the team about their treatment. Aside from the free lunch, such companies are trying to prove the worth of their treatment. How do we then decipher whether something is actually safe for patients and is effective for their disease? Here are some practical steps:
We must have a framework for assessing evidence. That dissertation we all did as part of our degrees wasn’t all-that useless! We’ve all come across the levels of evidence as well as useful constructs such as sensitivity and specificity. These help us determine the value of interventions and tests. I guess it’s time for a refresh!
Have a look at the levels of evidence including RCTs, case control, cohort studies and others. It’s the same ideas that you encountered during your dissertations.
Research the company itself. A quick google search will reveal their links to any “questionable industries”. Are there any undeclared interests?
Signpost your patients to verified, evidence based institutions. This isn’t restricted to NICE as it also includes websites such as Patient UK which is thoroughly evidence based.
Lastly, you can always ask us! We love looking at evidence and reading through papers as it’s what we do on a day to day. We have an awesome WhatsApp group with an active community and if you wish to join, email us directly.
Until next time!
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