Macy Foundation Chairman’s Report MECC

Representatives of the Alliance for Continuing Medical Education section representing MECCs and NAAMECC chose not to provide me with reflections on the Macy Foundations Chairman’s report. However, there was a document distributed during the January 2008 meeting of the Alliance for Continuing Medical Education by NAAMECC and Coalition for Healthcare Communication. It begins with the following Statement:

We applaud the effort to discuss important CE issues and share the group’s interest in

• providing high quality, unbiased education with the purpose of improving health professional performance and patient health
• To improve the quality of patient care by promoting improved clinical knowledge,
  skills and attitudes and by enhancing practitioner performance
• To ensure the continued competency of clinicians and the effectiveness and safety of patient care
• To provide accountability to the public”

The statement goes on to make the following 15 observations:

• The document is a conference summary from the Chairman’s perspective
• The summary may not fully represent the views of all attendees and their institutions, and it is unclear if the document represents consensus
• The 36 attendees did not represent the full spectrum of CE stakeholders, thus limiting the value of the recommendations and introducing serious opportunity for bias
• The summary includes a series of recommendations that could significantly alter the CE system and infrastructure, the consequences of which are unknown
• The summary recommendations would essentially eliminate commercial support for CE, thereby cutting funding by at least 50% for certified CME alone
• The summary recommendations for CE funding would require significant support from non-traditional sources, including the federal government, which may not be realistic
• The summary recommendations do not appear to be evidence-based, rather they seem to be pre-determined by the agenda and selection of participants
• The summary ignores the fact that all provider types have funding and policy priority challenges
• o The summary fails to recognize the importance of commercial support to improvements in patient care (Agency for Healthcare Research and Quality, February2007)
• The summary misuses standard medical education terminology (e.g., referring to commercial supporters as “sponsors” and incorrect use of the term “accredited”)
• The summary ignores ongoing and increased efforts to ensure independence and decrease bias
• The summary includes no evidence of the Foundation’s or individual participants’ disclosure of personal relationships with industry, conflicts of interest, or attempts to resolve any such conflicts
• The summary ignores basic legal principles of free enterprise and competition and the dangers of monopoly and antitrust (refer to the NAAMECC monograph featuring leading legal experts; see www.naamecc.org)
• The summary recommendations would limit free speech by both providers and supporters
• The summary recommendations would eliminate competition, thereby limiting innovation

For one, I look forward to a more considered response of this segment of the CME enterprise after the publication of the full report.