Independence from industry cannot be compromised.

Collaboration between clinicians and the pharmaceutical and medical device industry has led to many of the medical advances in the past century. When managed appropriately, relationships between clinicians and pharmaceutical companies benefit patients and enhance the practice of medicine. However, the authors’ recommendations for facilitating industry engagement in clinician education in Europe, if implemented, would cause serious, negative consequences for the quality and integrity of clinician education, professionalism, and self-regulation, and would erode the public’s trust in our profession. Though industry and medicine share the overall goal of improving health, their interests and obligations can and do diverge. Medicine has a primary responsibility to put the needs of patients first. Accredited continuing medical education (CME) holds that same responsibility. In contrast, corporate entities have a responsibility to their shareholders and other vested stakeholders to thrive as businesses and maximise returns on investment. Thus, pharmaceutical employees are fiduciary to their company’s business interests, and are often incentivised to increase their company’s profits. There is a large volume of evidence that incentives provided to clinicians in educational environments (such as gifts and compensation for speaking engagements or for programme attendance) can and do lead to corrupt practices even though many clinicians consider themselves immune to these marketing tactics [1]. These inappropriate incentives have resulted in the misuse of educational environments to promote products and to influence prescribing behaviour in ways that adversely affect patients, public health, and healthcare costs. Concerns about physicians’ relationships with industry have continued to grow as evidence has accumulated about the influence of such relationships on physician practice [2]. A consensus has emerged in the USA that recognises the enormous value of maintaining strong relationships between medicine and industry, notably in research and innovation, but equally recognises the need for circumspection where industry influence on physician education is concerned. Evidence demonstrating the influence of commercial manufacturers on clinician behaviour led the Accreditation Council for Continuing Medical Education (ACCME), the American Medical Association, and others to adopt guidelines related to industry funding of these programmes and the participation of speakers who have industry relationships [3,4].