{"id":9171,"date":"2019-04-14T17:03:52","date_gmt":"2019-04-14T21:03:52","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=9171"},"modified":"2019-04-18T16:01:18","modified_gmt":"2019-04-18T20:01:18","slug":"heres-one-rule-of-medical-education-that-needs-fixing-or-at-least-a-little-context","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/heres-one-rule-of-medical-education-that-needs-fixing-or-at-least-a-little-context\/2019\/04\/14\/","title":{"rendered":"Here’s One “Rule” of Medical Education That Needs Fixing — Or at Least a Little Context"},"content":{"rendered":"

Like any card-carrying ID doctor, I enjoy teaching about antibiotics. Give me a whiteboard (small group), or a PowerPoint set-up (lecture hall), and I’m off and running.<\/p>\n

Not surprisingly, an important theme of these talks revolves around avoiding antibiotic overuse. Over the years, I’ve collected a few egregious examples of how marketing distorts public perception of antibiotics — and, in particular, their indications.<\/p>\n

These images are fun to show in my talks — and, quite explicitly, to mock.<\/p>\n

Here’s one:<\/p>\n

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Free Antibiotics! Just in time for “Cold and Flu Season!” How generous!<\/p>\n

And here’s another, an ad I spotted on the NYC subway a couple of years ago:<\/p>\n

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“Very, very strong antibiotics” for someone who “sneezed.” Brilliant. Those strong antibiotics<\/em> will be just the thing.<\/p>\n

Let me state the obvious — these ads reinforce the very wrong belief that people with viral respiratory tract infections benefit from antibiotics. This misconception drives much of the inappropriate antibiotic prescribing in outpatient care and emergency rooms.<\/p>\n

By showing the images, I’m hoping to demonstrate just how pervasive these incorrect views are. It’s a brief and entertaining (I hope) diversion from the more didactic parts of the talk.<\/p>\n

But not so fast — the last two times I submitted slides for post-graduate courses, I received notice that these images were in violation of Accreditation Council for Continuing Medical Education<\/a> (ACCME) standards, specifically:<\/p>\n

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STANDARD 4.3<\/div>\n
Educational materials that are part of a CME activity, such as slides, abstracts and handouts, cannot contain any advertising, corporate logo, trade name or a product-group message of an ACCME-defined commercial interest.<\/div>\n<\/blockquote>\n
Ugh. Standard 4.3, of course!<\/div>\n

But here’s a question for the ACCME folks — doesn’t the context of these images matter? This usage is hardly promotional. It’s just the opposite, I’m making fun of these ads<\/em>.<\/p>\n

And here’s a second question — do you think we live in an advertising-free world? Wouldn’t the learners’ education be furthered<\/em> by seeing examples of how misleading commercial claims can be?<\/p>\n

One of the two courses relented when I made my point — slides stayed in. The other one, no such luck. I’m taking my revenge out on this inexplicable ruling by posting the images here.<\/p>\n

But all this back and forth reminded me of this quite brave (and brilliant) statement by the iconoclastic Dr. Vinay Prasad<\/a>\u00a0— who no doubt expresses what many medical educators have thought over the years, but never have been so bold to say:<\/p>\n

https:\/\/twitter.com\/VPrasadMDMPH\/status\/1114221315265679360<\/p>\n

And since Tom Lehrer just turned 91, and this is a post about education<\/em>, I can’t resist sharing this brilliant song and video:<\/p>\n