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Professional medical associations should not accept contributions from pharmaceutical and medical device companies, and the leaders of medical associations should be free of any conflicts of interest during their tenure, according to a report.

There are no reliable data quantifying the extent that medical associations rely on industry support. Some organizations may derive more than 50% of their operating budgets from pharmaceutical and medical device companies. The fact that exact figures aren't known underlines the problem of transparency related to industry support, coauthor David J. Rothman, Ph.D., said at a teleconference unveiling the report, which analyzes conflicts of interest and proposes guidelines for resolving them.

It will take time to phase out this financial support, but medical societies should immediately restrict total industry support to no more than 25% of their operating budgets, wrote Dr. Rothman, president of the Institute on Medicine as a Profession at Columbia University, New York, and his associates. "We really want to make certain that the recommendations, the education, all that professional medical associations do reflects best evidence [and] well-known and correct practice, and has no link or tie whatsoever to the world of marketing," he added at the teleconference.

In particular, practice guideline authors were scrutinized for conflicts of interest. For guideline authors to simply disclose relevant ties is not enough, asserted Dr. Steven E. Nissen, past president of the American College of Cardiology. "[Writing] guidelines to teach other physicians has to be done with the highest level of professional integrity. Unfortunately, that cannot be done when there is industry money involved," he said at the teleconference.

Industry-sponsored satellite symposia also were criticized. "Over the last 20-30 years, there has been an expectation somehow that somebody else pays for continuing education," said Dr. James H. Scully Jr., medical director and CEO of the American Psychiatric Association. "There's going to need to be a cultural shift of some kind where doctors are going to think about purchasing their own CME." This likely will drive the demand for higher-quality education, he said.

"We need a new paradigm," he added.

Revenue from advertisements in association journals and sponsored exhibit hall booths at annual meetings were exempted from the recommendations (JAMA 2009;301:1367-72).

Dr. Catherine D. DeAngelis, a coauthor of the report, is editor in chief of JAMA and has recently come under fire for refusing to release documents related to the confidential peer-review process for studies on cyclo-oxygenase-2 inhibitors, and for publicly criticizing a JAMA reader for pointing out missing disclosure data in a 2008 article.

This study was supported by the Pew Charitable Trusts. The authors emphasized that their recommendations do not necessarily represent the views of their affiliated organizations.