CME in the News and on the Blogs January 1, 2010

Here is an article you may want to read. I wish we would see more of these kinds of things circulating on the Blogs.

Commentary: Urgently Needed: A Safe Place for Self-Assessment on the Path to Maintaining Competence and Improving Performance

Bellande, Bruce J. PhD; Winicur, Zev M. PhD; Cox, Kathleen M.

Academic Medicine:

January 2010 – Volume 85 – Issue 1 – pp 16-18

Abstract:

Traditional continuing medical education (CME), necessary for keeping physicians current and competent, is insufficient in translating physician practice into better patient outcomes. CME, then, must be transformed from a system of episodic interventions to a more personalized, contextual, flexible, and targeted process within a continuing professional development framework. The core of this transformation must be a formal process of physician self-assessment. Unfortunately, health care providers tend toward inaccurate self-assessment, regardless of training, specialty, or manner of self-assessment. Therefore, the development of an external validation system conducted by credible, informal peer review in a safe environment is essential. Clinicians must be able to access practice and patient data without concerns about accuracy, timeliness, confidentiality, attribution, or unintended consequences. New analytical tools are also needed to illuminate the data compilations and present them in compelling, individualized, and comparative formats. However, such developmental work will not be possible without strong community leadership coordinating a collaboration of resources and a sharing of data. Ensuring physician competence has long been an issue for medical societies, state licensing boards, and others invested in improving patient care. Now it’s time to get serious. Current efforts at massive health care reform provide the perfect opportunity to fully integrate physician self-assessment and performance improvement into the larger health care system through a continuing professional development model. Practitioners in CME have been far too complacent with the current practices. A shift to a focused and dedicated sense of urgency must occur to ensure physicians’ continuous learning and change.

(C) 2010 Association of American Medical Colleges

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There is also a series of articles in this issue  on industry relationships that you may want to read.

Can Academic Departments Maintain Industry Relationships While Promoting Physician Professionalism?

Dubovsky, Steven L.; Kaye, David L.; Pristach, Cynthia A.; DelRegno, Paula; Pessar, Linda; Stiles, Keith

Academic Medicine. 85(1):68-73, January 2010.

Commercial Influence and Learner-Perceived Bias in Continuing Medical Education

Steinman, Michael A.; Boscardin, Christy K.; Aguayo, Leslie; Baron, Robert B.

Academic Medicine. 85(1):74-79, January 2010.

The Effect of Industry Support on Participants’ Perceptions of Bias in Continuing Medical Education

Kawczak, Steven; Carey, William; Lopez, Rocio; Jackman, Donna

Academic Medicine. 85(1):80-84, January 2010.

Perspective: Conflict of Interest and Professional Organizations: Considerations and Recommendations

Camilleri, Michael; Parke, David W. II

Academic Medicine. 85(1):85-91, January 2010.

CME in the News and on the Blogs December 29th, 2009

Here is a good news story for those of us working hard to serve physician learners. Recognition of excellent work by a CME colleague. Congratulations to Nadine Pieniaszek.

Bayhealth Names Educator of Year

Cape Gazette.com, December 28th, 2009

“When most people think about librarians, they think about the wizened, bespectacled, white-haired woman who testily shushes noisy library patrons and exudes all the personality of the Dewey Decimal System.

But that’s before they meet Nadine Pieniaszek (pronounced “pen-a-zak”).

Bubbly and radiant, Pieniaszek is not your typical librarian. As the Bayhealth Medical Center Librarian and Continuing Medical Education (CME) coordinator, Pieniaszek, MLS, provides physicians and clinical staff with the most current and reliable medical information. And, she devotes herself fully to library patrons so they can become independent in navigating the library universe…………..”

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CME in the News and on the Blogs December 19th, 2009

NOTE: These kinds of stories help flame the fires of legislative interference in CME related to disclosure, gifts to physicians, etc.

Hospital Docs Travel Widely on Taxpayers Dime

WSJ’s blog on health and the business of health.

By James A. White, December 18, 2009, 3:15 PM ET

“Where’s the best place for doctors at a county hospital in Northern California to keep up to date with medical developments?

Auditors looking at three years of spending on continuing medical education found 339 docs at Santa Clara Valley Medical Center spent time in Canada, Mexico, Switzerland, Italy, South Africa, Puerto Rico, Spain, China, Aruba, Thailand, the West Indies and the Bahamas, the San Jose Mercury News reported. More than one-third of the educational trips during the audit period were to Hawaii; the docs logged only 8% of their CME units in California, the paper said…..”

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CME in the News and on the Blogs December 18th, 2009

NOTE: More on the NEJM article calling for a pooled fund to support CME. There are some models in practice doing something like this but not a potential onerous as a “superfund”. I wonder if the people calling for this approach have even examined these models. I doubt it. As for me, I hope the “Superfund” idea crashes and burns.

HHS Inspector General Renews Call for Independent CME
GoozNews, December 17, 2009

“Following up on his testimony before the Senate Committee on Aging last July, Health and Human Services Inspector General Lewis Morris and colleague Julie Taitsman renewed their call for severing all ties between industry and continuing medical education. In an article in the current New England Journal of Medicine (subscription required), they also outlined an industry pooling arrangement as a halfway agenda for limiting industry influence over CME.

A “pooled-funding mechanism, using safeguards to ensure that CME programs serve an educational need and that industry donors cannot influence CME content, offers a promising compromise solution that may allow the medical profession to enjoy subsidized CME,” Lewis Morris, chief counsel to the OIG, and Julie K. Taitsman wrote………”

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NJ AG’s Office Has Recommendations on Doctor/Industry Conflict of Interest
Astrid Fiano, DOTmed News Writer, December 17, 2009

“New Jersey Attorney General Anne Milgram has released a report from the Division of Consumer Affairs that recommends new regulations to avoid conflicts of interest between doctors and pharmaceutical companies and medical device manufacturers……”

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The New Jersey Attorney General’s press release with the report can be accessed here.

NOTE: Here is something those of us looking for resources to answer FAQ’s about CME might find useful. It is from the University of Utah Office of CME.
The University of Utah Continuing Medical Education (UUCME) FAQs
Office of Continuing Medical Education

You’ll find the resource here:

CME in the News and on the Blogs December 17th, 2009 [2]

Conflict of interest in continuing medical education

Healthcare Etc., December 17, 2009

“…..In this week’s NEJM, there is a piece from the Office of Inspector General of the US Department of Health and Human Services titled “The Agenda for continuing Medical Education — Limiting Industry’s Influence”. In this article Morris and Taitsman lay out the issues and potential solutions. And while the problems are quite apparent, sensible solutions are scarce. The problems may be summarized as the undue influence by the Industry stake holders on the content of physician education. To understand this mouthful, one has to be familiar with the structure of the CME establishment……”

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CME in the News and on the Blogs December 17th, 2009

Note: This is getting ridiculous.

DC City Council Holds Hearings on Area Physicians Relationships with Industry

Policy and Medicine, December 17^th, 2009

“The District of Columbia City Council Committee on Health last month held a hearing regarding various health care related issues.   Included in the hearing was “charges” read out by Health Committee Chairman David A. Catania.  These included reading the names of physicians (top researchers in the district) along with information on their relationships with industry credited as provided by a specific member of US Senator Charles Grassley (R-IA) staff.

The meeting gives us a glimpse into the current state of “transparency” where at one point Mr. Catania reads off “charges” against six area physicians who’s crimes are that they worked for industry.  This included sending subpoenas to all six physicians to show up a hearing on December 19, 2009.  He also provided warnings to local universities and hospitals that they should adopt to severe conflict of interest restrictions or face the consequences. ……..”

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CME in the News and on the Blogs December 14, 2009

Note: This article addresses the issue of doctors keeping up to date. It is worth a read. CME is mentioned. We all are aware that knowing is not enough. But not physicians not knowing may be hazardous to my health.

Doctor’s Orders: Practicing Evidence-Based Medicine Is a Challenge
By Todd Neale, Staff Writer, MedPage Today
Published: December 12, 2009

With the amount of research being published in medical journals and presented at meetings, it should not be surprising when a new finding slips by a busy physician.

Nor should it be surprising, then, that some decisions about patient care might be made without benefit of the most recent evidence………….”

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NOTE: You need to read this next one. Regardless of your position on this issue you’ll find some of the opinions held by Dr. Brodkey interesting to say the least. A fact check could prove to be interesting on this one. And some of  the opinions expressed show a definite bias.

A Question of Ethics: An Expert Interview With Amy Brodkey, MD
From Medscape Psychiatry and Mental Health, December 12, 2009, by Pippa Wysong

“Medicine is fraught with questions relating to the ethics of relationships between physicians and industry. Should doctors accept gifts from industry, and does it matter if it’s something small like a pen or free lunch? At what point can interactions with industry representatives become a conflict of interest or influence practice? Is it ethical to give patients free drug samples? These and other questions were posed to Amy Brodkey, MD, an adjunct associate professor of psychiatry at the University of Pennsylvania who has studied the relationship between physicians, industry representatives, and conflict of interest. She is also on the board of No Free Lunch, a nonprofit organization encouraging greater distance between physicians and industry……………..”
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CME in the News and on the Blogs December 10, 2009

ACCME Testing Online System to Collect, Evaluate CME Activity Data: PARS Expected to Go Live in Early 2010

AAFP News Now 12/9/2009

“The Accreditation Council for Continuing Medical Education, or ACCME, is testing an online reporting system designed to improve the transparency, efficiency and accountability of the CME enterprise, as well as to save CME providers time and hassle by streamlining the accreditation process. The Program and Activity Reporting System or PARS, is a Web-based portal that will permit the ACCME to collect and analyze up-to-date, comprehensive data from ACCME-accredited CME providers…………..”

You will want to take a look at the PDF file describing this effort. There is a link to follow in the article.

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CME in the News and on the Blogs December 8, 2009

IOM Report: Redesigning Continuing Education in the Health Professions

If you are in the business of CME you need to at least read the Executive Summary of the IOM report “Redesigning Continuing Education in the Health Professions”. There are a lot of far reaching suggestions made by this group.  Some should crash and burn. But you make up your own mind.
Go here:

Ponder the implications of these and similar recommendations. If implemented, the impact will ultimately been seen in the quality of patient care in this country. I see no viable options to our currently flawed system being suggested. This is irresponsible on the part of those holding some of the extreme opinions reflected in this report. And those who hold opposing opinions seem to be mute. Be careful what you ask for.

Organizations Receiving Latest Inquisition From Grassley

12-08-09

Here are the organizations receiving Senator Grassley’s latest letter of inquiry.

Senator Grassley’s letter of inquiry to the AAOS, the Alzheimer’s Association, the AAAAI, the American Academy of Dermatology, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Surgeons, the American Dental Association, the American Diabetes Association, the American Dietetic Association, the American Heart Association, the American Hospital Association Inc., the American Medical Association, the American Psychological Association, the American Society of Anesthesiologists, the American Society of Colon and Rectal Surgeons, the American Society of Consultant Pharmacists, the American Society of Health System Pharmacists, the American Society of Hypertension, Inc., the American Society of Nephrology, the American Society of Plastic Surgeons, CHADD, DBSA, the Heart Rhythm Society, Mental Health America, NARSAD, the National Association of Chain Drug Stores, NORD, NASS, Screening for Mental Health Inc., TeenScreen, The Leukemia and Lymphoma Society, and the American Cancer
Society.

To see the letter and what Grassley is requesting from these organizations and the letter referred to by Grassley go here.