While I agree with Dr. Henry Nasrallah that pharmaceutical companies’ policies need to be changed (“Breakthrough drugs and sponsorless CME: How the FDA can help,” From the Editor, Current Psychiatry, April 2008), I believe he overlooked the larger moral question and a potential intervention. Every dollar psychiatrists accept for personal use—no matter how free from bias— is one that could have been used to benefit our patients.
As physicians we need to set aside our deeply ingrained feelings of entitlement and assume responsibility for our education and sustenance. I can buy my own books, notepads, lunches, and even continuing medical education (CME). I cannot provide expanded patient assistance programs or lower medication costs. A pooled not-for-profit fund is an excellent idea; why not use it to buy generic medications for resident clinics to distribute free of charge or other patient-centered activities?
I recognize that funding CME without industry sponsorship would be difficult and would require fewer creature comforts and more funding from physicians. It likely will require creative use of Web-based teleconferencing, information sharing, or even streamed, prepackaged lectures from recognized experts. In the end, however, I believe a greater commitment to teaching each other and active learning will provide a greater benefit to ourselves and our patients.
Travis J. Fisher, MD
Medical College of Wisconsin
Milwaukee, WI