"EXCEL" Meeting Minutes
September 25, 2002

Present: Tim Thompson, M.D., Ginny Fry, Diana Peirce, Maureen Fraser, John Campbell, Bob Orr, M.D., Madeleine Mongan, and Anne Coates

PURDUE PHARMA GRANT-

Tim began by asking the committee how they felt about expanding ExCEL to include an educational arm. He went on to describe a recent conversation he had with Paul Harrington which centered around having the VMS develop their own educational trust that would in part fund pain management/palliative care training for physicians across the state.  He then reported that if the committee does accept a grant from Purdue Pharma, they would have free, unrestricted capacity to the grant. Purdue is open to any kind of proposal from the committee because they are trying to get back into palliative care. In fact, Maine now has a grant from them for their own educational arm.

Diana pointed out that most disciplines are currently funded by pharmaceutical companies. Tim told the group that he recognizes that there are a lot of cautionary issues  they would have to be mindful of if they choose to proceed with the grant from Purdue. He went on to say that at the same, they are limited in their funding options. Bob expressed reservations about forming a relationship with any pharmaceutical company. He mentioned that FAHC has stopped resident lunches with the companies because it presents a conflict of interest.

Tim stated that they could negotiate how Purdue’s name is presented in their pain management workshops/conferences. He feels the most important thing is to obtain money for pain management education. There are tremendously underserved areas in the state which is why this grant could be so beneficial. John asked if we would have to promote their drugs if we accepted their money. Tim responded by saying in so far that their drugs are standard drugs of care. John and Tim both agreed that it was worthwhile to solicit support outside of Purdue.

Madeleine reiterated that it was a great idea to develop an educational arm. It would be important to solicit support from physicians as well as drug companies and other corporations. The interest in doing it would be for a number of reasons such as supporting students at the College of Medicine.

Tim asked Bob what the College of Medicine’s stance was with regards to pharmaceutical companies. Bob was unsure but Madeleine added that 40% of CME is through drug companies. Thus, there would be a big hole if funding was taken away.

John made the suggestion that maybe they could accept financial support from Purdue and or other pharmaceutical companies for pain management education but decrease their dependency on them after each year.

ACTION-

Anne and Madeleine will draft a letter to Purdue Pharma that will outline the goals of the committee. Prior to doing that they will inquire with the council on how they feel about the grant.

Tim asked the committee if they had to have guidelines to working with drug companies? Madeleine suggested that he look at the AMA guidelines to see how they would fit in Vermont. She also suggested that ExCEL’s guidelines be in line with FAHC and DMHC. Madeleine was aware of a “No free lunch website” that was active at DMHC.

ACTION-

Bob will share FAHC’s policies with the committee once they are established.

Anne and Madeleine will help survey the hospitals in the state about their drug sample distribution, CME trials and how their respective pharmacies operate.

Ginny will send Anne a copy of the letter she sent to Purdue last year.

PAMPHLET-

Bob announced that he is working on a project of guardianship. A group is trying to put together a booklet that would help guardians make decisions for people who cannot make their own decisions. To date, there have been a couple of different drafts of the pamphlet.

Tim asked if the pamphlet will be publicized and John responded by saying some time in the spring.

MEDICAL MARIJUANA-

Tim told the group that Dr. McSherry had drafted two resolutions in favor of the decriminalization of marijuana. Although VMS’s council did not express any support of them, they will be discussed at the annual meeting.

MEDICAL PROFESSIONALISM-

Tim referenced a recent article from the British Medical Journal that discussed why so many physicians were burning out. He felt the more likely physicians are to care, the more likely they are to burn out. It is important to educate our physicians on the skills that will decrease their chances of burning out. Ginny thought that maybe physicians aren’t being supported in the ways they are educated to be. Diana went on to say that nurses, physicians, counselors need to depend on each other.

Conversation ensued on this topic before Tim wrapped it up by stating that professionalism issues are part of the medical society. He is not sure how to think about them in a productive fashion.

NEXT MEETING-

Wednesday, November 20^th              2:00pm to 4:00pm at VMS