Where (How) Can We Make a Difference in the Current CME Environment?

May 12, 2009 at 11:52 pm Leave a comment

I was talking to a colleague who happens to work in pharma asking for some advice on an issue of concern to my organization. In the conversation we wandered off to talk about the current state of our CME enterprise. He asked me an interesting question. It went something like this. Floyd, if you could position yourself in the CME world where you could make the greatest impact for positive change, where would that be? Here is my response.

“I’m afraid I mumbled and wandered around a bit when responding to your question about where to make the biggest impact on what is going on in CME right now. Honestly I don’t know.

There is not a representative group in the field effective enough to make the kind impact needed. The Alliance will not step up to the challenge. The Conjoint Committee on CME has the players around the table but has some of the wrong players at the table (e.g. ACCME ACGME). ACCME is absolutely not the group to provide the leadership. SACME, NAAMECC, etc. are too narrowly focused. I hate to see federal legislation shape our future but I think it will have some role.

There is much to be done.

• The role of Pharma and an effective model for its involvement in CME is just one of the challenges facing CME. The withdrawal of pharma funding for CME will not end the role of pharma in physician education. It will change the independent nature of CME.
• The accreditation system is onerous but has some excellent components. One way to shake that up is to work to have the AMA withdraw from the ACCME and take its CME credit with it. I am working with one AMA constituent to bring a resolution to the AMA House of Delegates with that resolution.
• Another thing that could have an impact is for an alternate accreditation system to emerge that would have the AMA blessing to approve Category 1 CME credit. A few of my more radical colleagues and I are thinking about designing such a system as a “paper tiger” to shake things up a bit.
• The AMA could abolish category 1 CME credit from the requirements for the PRA.
• The AMA could change what kinds of activities would qualify for Category 1 credit – eg. PI only. I’ve made that suggestion in the past on several occasions.
• Every State with mandatory CME requirements to drop the requirements in the absence of data to show impact.
• The FSMB could mandate performance improvement initiatives as a condition of licensure but not rely solely on MOC to meet the requirement.
• Etc etc etc

I honestly think the biggest push for quality CME is currently coming from the pharma companies that “get it” and refuse to fund activities that do not meet the medical professions criteria for quality CME. But as you point out many of these companies don’t get it. I think the collaborative grants model is one mechanism to give serious consideration. I am adamantly opposed to the ACCME “super fund” idea but think there is middle ground that could work.

I am in a quandary as to how to answer your question intelligently. One thing I am convinced of – every system is perfectly designed to get the results it gets. If we are not getting the desired results from the current CME system – that system has to change. Bottom line – the CME system in this country has to change. How we get there is the question we need to think about very seriously and very soon. If we don’t, failure is not an option, it is inevitable.”

How would you answer this question.

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Entry filed under: CME, CME Issues, Continuing Medical Education, Continung Professional Development, Pharma Funding, Physician Education.

Sure. Go Ahead. Ban Pharma Money From CME. Pharma Influence in Continuing Medical Education: One Welcome Contribution

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