I often have a difficult time describing just what I do for a living to my friends and family. It should be simple, but it just never is. I always start out by saying that I work in continuing medical education; and, like it or not, that is what I do. But then I try to describe it more fully, with the intricacies of academic providers and private providers, the debate around fee-based activities and commercially supported activities, the benefit of “one and done” activities as opposed to larger, multiplatform initiatives. And then, how do I answer the question of how we measure success? (This will be the subject of its own article in the coming months.) Did I forget to mention the ever-changing role of governmental oversight? This ain't easy.

Existential Crisis

So I began to ponder: What exactly do I do? I try not to ask the similar question: “Who am I?” (as this might lead to years of costly therapy). So, to focus then, what do I do? I suppose that I am a businessman, since I have to run a profitable business. But I don't manufacture a product (or do I?) or sell a service (or do I?). If I only provide commercially supported CME, I don't have customers, so I am not in customer service (or am I?).

Thinking further, I began to worry that I don't have a clearly defined career at all. I am in a profession that doesn't manufacture products or work on a fee-for-service basis, I don't have clients, and although I seek funding for my activities I cannot provide a standard return-on-investment model.

The Missing E

What exactly is it that I do? I think that, by default, anyone involved in the design, development, and delivery of certified CME activities is an educator. So, I must be an educator! Sometimes this is forgotten, and the E in CME gets lost. We are educators, and whatever else we do makes us better and more effective educators.

The picture got clearer — the end product of my efforts is educational activities, so I do “manufacture” a product. The products differ in size, shape, and form, but they have a consistent makeup: information. The product is based on sound market research that is better known as a needs assessment. After all, I wouldn't manufacture a product that didn't have a market.

I began to feel a bit better, so I continued to think about my profession. I believe that I do have customers, but not in the traditional sense. The learners who participate in the educational activities are my customers. They are educational consumers, and I provide them with products and — in some cases, services — that they need. Whether they are charged for the activity is not a factor; similarly, if I listen to music on an FM radio station (while they still exist) in my car, I am receiving the music for free, but I am still a consumer and a customer of the radio station. I can choose to listen to any channel that is available, but I select one particular station.

Am I providing a service to commercial supporters? Not in the true sense, as the rules of independence prohibit a traditional client/vendor relationship. I do, however, feel that as the recipient of an educational grant, I need to provide the supporter with some level of service, be it as simple as periodic updates on the use of the funds or as complex as an analysis of the overall impact of the education that was funded. So, in a sense, I am providing some level of service to commercial supporters as well.

Now what do I say when people ask what I do for a living? Do I say that I am in a profession that is a nontraditional, service-oriented manufacturer of measurable educational activities? Nope. I will just continue to say that I work in continuing medical education. It's what I do, and it's a whole lot easier to say.

Lawrence Sherman, FACME, is president and CEO of Physicians Academy for Clinical and Management Excellence, New York. A 12-year CME veteran, he is a frequent lecturer on topics related to the strategic development, dissemination, and evaluation of CME activities. Reach him at LS@physacad.com.