A conversation has been going on recently on the Healthy Skepticism list-serv about how hard or how easy it is for physicians to stay up to date on new drugs and therapeutics without relying on sources that are controlled or heavily influenced by the pharmaceutical and device industries and their marketing juggernauts. Dr. Mark McConnell, who practices internal medicine in LaCrosse, WI, offered a set of highly practical tips that seemed too good not to share with all readers. He's given me permission to reproduce his how-to list, to which I have just a couple of additional suggestions.
Dr. McConnell states that by adhering to his program the necessary investment of time needed to stay reasonably informed and up to date is about 5-10 hours per month. (Like anything else, I'll add, when you just begin to start using any of these sources, it will take a bit longer; once you become used to how each works and where to locate the information you need, your time will shrink.) Dr. McConnell notes that he does not have a specific set-aside budget for CME and so he uses his own funds for these programs and sources.
His core resources:
Oakstone's Practical Reviews in internal medicine
InfoPOEMs from Essential Evidence Plus
Therapeutic Initiatives Drug Therapy review course
I just have two additional resources to comment on. One is a service that provides a monthly CD with an audio presentation and evidence-based discussion of 40 recent articles pertinent to primary care, along with a database that allows you to store all 40 abstracts each month on your computer and later search them--Primary Care Medical Abstracts, http://www.ccme.org/PCMA/index-frame.html, $279/year. Rick Bukatra and Jerry Hoffman present, discuss, and argue about the abstracts in a manner somewhat reminiscent of "Car Talk" on NPR.
Second, I have been a long-time satisfied subscriber of The Medical Letter, http://www.medicalletter.org/, $98/year. This is supposed to be the Granddaddy of all U.S. non-commercially-sponsored publications on therapeutics, having been founded in 1959. The Medical Letter was being criticized on the HS list for not being truly independent and for allowing companies to review its assessments of their drugs. All I can say in defense of my longstanding use of this source (when I was in practice, which I am not currently) is that the publication hardly ever endorses a new drug, and most often says that a new drug is really no better than an older drug. The few times I have mentioned this publication to a drug rep, he has pooh-poohed it vigorously and given me numerous reasons why I should pay no attention. So if the drug companies are allowed to see the reviews, it does not appear that they have much influence over what is eventually published. I'd appreciate more discussion of this in the Comments.
None of the above sources accept ads from industry.