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To the Editor: In their Special Communication, Dr Rothman and colleagues¹ noted that "extensive literature has documented the influence of gifts on individual physicians." To my knowledge, there is no similar evidence showing that commercial support of continuing medical education (CME) has the same influence, either on physicians or on their professional medical associations (PMAs).

The best current evidence is a study commissioned by the Accreditation Council for Continuing Medical Education (ACCME) and not published in the peer-reviewed literature.² Additional high-quality evidence in this area would add to this already valuable national discussion.

It is critical to recognize the implications of the difference between relationships of individual physicians with industry and grants from industry to PMAs for independent CME. Based on the evidence, few of the authors' recommendations follow convincingly. One which does, however, is that committees crafting clinical practice guidelines should be composed of members without ties to industry, . . . [Full Text of this Article]

Norman Kahn, MD
nkahn@cmss.org
Council of Medical Specialty Societies
Chicago, Illinois

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