In addition to complying with subdivision (b) of Section 3635, the following shall apply to providers of continuing education:
(a)
The content of continuing education courses and related materials shall provide balance, independence, objectivity, and scientific rigor. All patient care recommendations from continuing education courses involving clinical medicine shall be based on evidence accepted by naturopathic doctors. All scientific research used to support patient care recommendations shall conform to generally accepted standards of experimental design, data collection, and analysis.
(b)
A conflict of interest is
created when an individual in a position to control the content of a continuing education course, or his or her spouse or partner, has a relevant personal financial relationship within the past 12 months with a commercial entity that produces, markets, resells, or distributes health care goods or services consumed by, or used on patients that benefits the individual in any financial amount and therefore, may bias his or her opinions and teachings with respect to the content of continuing education courses. This may include receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest such as stocks, stock options or other ownership interest, excluding diversified mutual funds, or other financial benefit. Financial benefits are generally associated with roles such as employment, a management position, or an independent contractor position, including
contracted research and clinical trials, consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected.
(c)
Prior to a course being presented, continuing education providers shall identify, disclose, and resolve all conflicts of interest. Individuals who fail or refuse to disclose relevant financial relationships shall not be approved as a provider of continuing education as described in subdivision (b) of Section 3635.
(d)
Conflicts of interests shall be resolved by one of the following mechanisms:
(1)
Altering financial relationships. Individuals may change their relationships with commercial interests, such as discontinuance
of contracted services, thereby eliminating any conflict of interest related to the continuing education content.
(2)
Altering control over content. An individual’s control of continuing education content may be altered in several ways to remove the opportunity to affect content related to the products and services of a commercial interest. These include the following:
(A)
Choose someone else to control that part of the content. If a proposed presenter or planner has a conflict of interest related to the content, someone else who does not have a relationship to the commercial interests related to the content may present or plan that part of the content.
(B)
Change the focus of the continuing education activity so that the
content is not about products or services of the commercial interest that is the basis of the conflict of interest.
(C)
Change the content of the individual’s assignment so that it is no longer about products or services of the commercial interest. For example, an individual with a conflict of interest regarding products for treatment of a condition could address the pathophysiology or diagnosis of the condition, rather than therapeutics.
(D)
Limit the content to a report without recommendations. If an individual has been funded by a commercial entity to perform research, the individual’s presentation may be limited to the data and results of the research. Someone else may be assigned to address broader implications and recommendations.
(E)
Limit the sources for recommendations. Rather than having a person with a conflict of interest present personal recommendations or personally select the evidence to be presented, limit the role of the person to reporting recommendations based on formal structured reviews of the literature with the inclusion and exclusion criteria stated “evidence-based.”
(3)
Conflict of interest may be resolved if the continuing education material is peer reviewed and both of the following are met:
(A)
All the recommendations involving clinical medicine are based on evidence that is accepted within the profession of naturopathic medicine as adequate justification for indications and contraindications in the care of patients.
(B)
All scientific research referred to, reported, or used in the continuing education activity in support or justification of patient care recommendations conforms to the generally accepted standards of experimental design, data collection, and analysis.
