The speakers’ bureau system: a form of peer selling | Reid | Array

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Conclusion

When the content of a physician’s presentation to any audience of physicians or other health care providers does not rest exclusively in the hands of the speaker and she or he understands—whether through an explicit term of a contract or an implied agreement—that the goal of the presentation is to increase uptake of a particular health care product, the physician is violating the CMA’s guideline against peer selling and the prohibition on product endorsement in the CMA’s Code of Ethics.
Although physician participation in promotional activities within the profession appears to be common, at least in some specialties, there is no record of disciplinary action in relation to this practice, even in provinces where regulatory colleges have adopted the CMA’s prohibition on peer selling. Academic medical centres in Canada, unlike those in the United States, may rely on the strong guidance of the CMA Code of Ethics prohibition on product endorsement in crafting institutional policies; however, they are not showing leadership in forbidding faculty participation in speakers’ bureaus. CME offices are in the process of clarifying and harmonizing policies, but they lack regulatory oversight of physicians’ activities outside of accredited CME. The current non-enforcement of the CMA guideline against peer selling in Canada adds new fodder to age-old debates about the merits of self-regulation in medicine. The failure of academic medical institutions and regulatory colleges to enforce the guideline against peer selling and product endorsement bolsters the argument for stronger government oversight of physician–industry interactions.