How Can Physicians Stay Current on Prescription Drugs?

Robert M. Centor, MD; Pennie Marchetti, MD; R.W. Donnell, MD; Roy M. Poses, MD

Disclosures

August 30, 2006

Robert M. Centor, MD: Require Standard CME Courses

How can we, as physicians, improve our use of pharmaceuticals and stay current on the expanding field of prescription medications?

During my 30-plus years since graduating from medical school, the number of available drugs has increased dramatically. My medical school pharmacology course may have helped me learn the general principles of pharmacokinetics, but it now provides almost no help in dealing with specific drugs.

Many patients take multiple drugs, and as that number increases, so does the number of potential errors, interactions, and side effects. Drug errors have become an increasingly significant problem because of this phenomenon of multiple prescriptions.

As an academic physician, I try to stay abreast of new drugs, especially new drug classes. I go to conferences, I read The Medical Letter, and I read medical articles on most days. Nonetheless, the amount of information that I could know still exceeds what I do know.

For us to improve our drug use (and decrease errors), we need a dramatic change in continuing medical education (CME) and we need intelligent electronic medical records.

Even though we physicians want to choose and direct our own continuing education, I believe we can no longer afford that luxury. As medical care increases in complexity, the knowledge demands increase even faster. We cannot afford to provide care without the proper knowledge acquisition.

I believe it is time to require all physicians to take and pass certain CME courses (a model many professions already adopt). We would need experts to develop the curriculum each year to direct the new knowledge that we must acquire. These courses would vary by specialty, of course, as neurosurgeons, radiologists, and dermatologists clearly have different educational needs.

Currently, we have ceded pharmaceutical education to the pharmaceutical industry. This practice leads to incomplete and biased education. We cannot afford to let industry determine the educational agenda. These companies always promote the newest (and often most expensive) options and rarely put these options into the appropriate context.

But even if we developed a superior educational model for pharmaceuticals, we still would need computer assistance. We need computers to remind us of potential drug interactions, for instance. Making potential interactions explicit would help us avoid many such problems.

The problem of drug errors will likely increase over the next decade unless we become proactive in prevention. We must all upgrade our knowledge each year because knowledge and new drugs are advancing so rapidly. We must take advantage of technology to help prevent obvious mistakes.

I hope that we will accept some drastic solutions to this growing problem. Some physicians might resent directed CME. However, I do not believe we have the luxury to continue our present haphazard learning.

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