AFTER 10 YEARS of attending Pharmaceutical Alliance for CME meetings at the Alliance for CME annual conference, Maureen Doyle-Scharff, director, professional services and medical education, Ross Products Division, Abbott Laboratories, Columbus, Ohio, was fed up. “I'm a very opinionated person, and I was moaning and groaning about how all of us get together and complain about the same things year after year and don't do anything about it,” she recalls. “And some people said, ‘If you think you could do something about it, why don't you just take over this group?’”
She agreed, warning that she is an action-oriented person and would make things happen. And that she has. PACME's achievements so far include developing a roadshow of Alliance for CME leaders, who visit pharma companies and educate personnel about the importance of CME provider/industry collaboration. Future goals include developing a curriculum to certify industry personnel in CME “rules of engagement” and creating a database of CME providers, highlighting their competencies, interests, and strengths.
Such strategies are especially critical now, because pharma companies, under increasing government regulation and public scrutiny, are reevaluating their role in funding CME. A passionate advocate of industry's involvement in CME, Doyle-Scharff says the CME community needs to make major changes to ensure the future of industry/provider collaboration.
In addition to leading PACME, she was elected this year to the board of the Alliance for CME — the first industry representative to win election in six years. She also serves on the board of the Global Alliance for Medical Education.
Doyle-Scharff's dedication to CME began 15 years ago when she joined a medical education company as a graphic artist and eventually was promoted to account executive. One of her clients was The Upjohn Co., which she joined in 1996 as a healthcare education services manager. Then, at Pharmacia, she served as director, professional affairs; when Pfizer acquired the company, she moved to Johnson & Johnson as executive director, alliances and advocacy. This April, she started her new position at Ross Products Division, Abbott Laboratories, where she will redefine and lead the professional services team.
Asked what attributes have enabled her to become a successful leader in the CME community, she answers, “I believe I'm an effective team builder, meaning I can bring a lot of disparate — sometimes desperate — groups together to sit down and identify common issues, common ground, and common goals and move forward from there.”
We sat down with her at the Alliance for CME annual conference in January, and followed up later over the phone to get her perspective on the future of CME provider/industry collaboration.
On the competencies CME professionals working in industry need to have in today's environment
DOYLE-SCHARFF: We're so myopically focused on the logistical issues of the [CME provider/industry] relationship that we're losing sight of the fact that we're still spending hundreds of millions dollars on education that isn't effective. In order for us to make the right decisions on where dollars should be invested, we need to be better prepared to appreciate and understand the connection between a true needs assessment and measurable outcomes. Ultimately it is the provider who needs to make the decision as to how those outcomes are measured. But I believe that [CME professionals in] industry need to elevate their competency level in the area of adult-learning principles in order to make sure that we are investing dollars in education that is meeting the needs of the physicians in our country and is ultimately having an impact on patient care in a positive way.
There are individuals who don't think [outcomes measurement] is important — or worse — feel that in the current regulatory environment it would give people the wrong impression. We're kind of in a “damned if we do, damned if we don't” situation right now. [How-ever], if we support medical education because we want to educate physicians, because we want to move them down a continuum to be better physicians and improve patient care, then we're on the right track.
On establishing guidelines forhonoraria
I don't believe industry should be making that call. Industry has the right to be prudent and review grants to protect its interests. Having said that, the exorbitant honoraria that are out there today have a lot less to do with providers and a lot more to do with industry practices of old. We need to accept a certain amount of that responsibility. [But] when we're talking about independent CME, it is the responsibility of the provider to determine fair market value.
On establishing standards for CME provider/industry collaboration
In a perfect world we would have some standards, including a common letter of agreement that the Food and Drug Administration and Office of Inspector General [would approve of]. If we can establish a set of standards and tools, we can start to chip away at some of the massive confusion and frustration that exists between [providers and industry].
To protect our interests, we're investing a lot of resources and money into internal processes, grant review committees, and online grant processing software — money that could be spent on quality education. I really believe in my gut that if we can see through the quagmire of complicated issues that we're facing and make sure that our guiding light is improving patient care and safety — and start working backward from there — then a lot of the challenges and anxiety and the fear around being involved with medical education will disappear. We will have the data to show the public and the government that our focus is on patients and that what we do is making a difference.
On who should pay for CME
An issue that should be at the top of everybody's list is balanced funding for continuing medical education. I do believe that the pharmaceutical and device industries have an appropriate role to play in this mix — but I do think that it's dangerous that 60 percent of the programs are funded by industry. Not because I think that industry dollars are a bad thing, but in today's world it's dangerous because of the perception. CME providers need to look at their business model and understand where else they might find dollars to fund their activities.
I would never discount the role the docs themselves should play in paying for part of this. I've heard this from attorneys, I've heard this from even the allied healthcare professionals — doctors are the only professionals in this country who don't have to pay for their continuing education, because it's subsidized by industry.
The best-case scenario is a balance, where docs pay for part of their CME and where the government picks up part of the tab. There are grants at the state level, and I think providers have never [asked for government funding] because the dollars have always been there from industry. A very good friend of mine said at the Alliance meeting that it's actually easier for her office to get money out of the government than it is to get money out of industry right now. I mean, that pretty much says it all.
I have a problem with the people on the provider side who view us as a necessary evil. That just perpetuates the anxiety and the myth that we're only in this because we want to sell more products. That is as far from the truth as one could possibly get. [CME providers] know that we're not the evil empire, especially the individuals who are at the Alliance for CME meeting, who make the commitment to be a part of the solution.
It's frustrating for me when providers or the CME community at large won't step up and be a voice for us. We get bad press every day of the week, from “The Simpsons” to “ER.” I often wonder: Where is the CME community? Where is academic medicine? Where are the specialty societies who know that this is a partnership, who know that without us they would have to pursue a different business model? [Up until now] all providers have had to worry about is their part of the world within their academic center or medical society. Unfortunately, the stakes are so much higher now. There's so much more work to be done and bigger problems to deal with.
On CME's role in the wider healthcare system
What are we going to do about the 100,000 medical errors that occur in this country every year? Whose job is it to help change that? The physician has a huge responsibility but the CME provider has a pretty big chunk of that responsibility as well. CME is not just about educating docs on the latest and greatest therapeutic advances — we need to be part of a movement that helps physicians become better physicians or at least competent by standards that are acceptable to all stakeholders, including the general public.
I do believe that CME can and will play a critical role in helping us solve many of the big problems of healthcare today, the cost issues, the waste, improving population outcomes. A lot of these issues are systemic, but education goes hand in hand with changing the system. I absolutely believe CME needs to be a critical component of [solving these problems], but we're never going to get there if we can't sort through the fundamental logistics of how industry provides dollars to CME. I hope that in five years or however long it takes, CME can finally take its rightful place in the whole healthcare marketplace.
Mom and Mr. Mom
During one of the many sessions she facilitated at the Alliance for CME annual conference this past January, Maureen Doyle-Scharff kicked off her presentation by showing a slide of her two sons, aged six and two, in their Halloween costumes. “These are my two boys — the two loves of my life, aside from my husband,” she said, adding that she had never put a picture of her kids in a presentation before. She did it to remind herself that she hadn't seen them for five days. “We are all making sacrifices, traveling a lot, because we believe in what we are doing,” she told participants.
Doyle-Scharff, director, professional services and medical education, Ross Products Division, Abbott Laboratories, Columbus, Ohio, not only has a demanding job, but her passion for CME impels her to take on additional responsibilities, such as speaking at conferences and becoming leader of the Pharmaceutical Alliance for CME — all of which involve a great deal of travel. So how does she balance career and family?
“First and foremost, my family really is my No. 1 priority and if I felt that my involvement in [the CME] arena or my job itself was interfering with that No. 1 priority, then I would make a change in my life,” she says. She also says she would not be able to pursue her career without the support of her husband. “I am married to a phenomenal individual who doesn't travel.” A high school science teacher, her husband is “a part-time Mr. Mom,” she says. And, she asserts that's a positive situation for her children. “My kids get to spend more time with their dad than most kids get to spend with their fathers, because our society is still backward in that vein. Everyone in my neighborhood is a stay-at-home mom. I'm a better mom and a better wife because I have a career I love and I'm passionate about things [beyond just] family.”