I read your article “Rethinking the Lifeline” (December 2007) addressing the federal scrutiny of pharma funding of CME. At the end of the article you asked for other strategies that have been developed to ensure CME's independence. We at the New Jersey Academy of Family Physicians use a strategy on a national level that passes any government scrutiny test: We design CME to address gaps in the quality of care that have been identified by government agencies, partner with government contractors, and deliver it where it is most needed.

If CME is addressing issues identified in the Center for Medicare and Medicaid's 8th or 9th SOW [Scope of Work], working in a symbiotic relationship with quality-improvement organizations, and targeting CME interventions to areas where the Centers for Disease Control have identified the greatest need, it won't matter if the grant comes from the pharmaceutical industry. Pay for Performance and HEDIS [Healthcare Effectiveness Data and Information Set] measures are all about appropriate, evidenced-based care for the patient. We should be incorporating these measures into our educational objectives to upgrade our learners' knowledge or skills as a routine part of every grant request.

We in CME need to change the adversarial perception that now exists and demonstrate to the government that we possess the unique skills to help achieve the goals they have set. There is nothing wrong with industry funding CME that closes gaps and improves the health of the population. The CME community needs to identify the agencies and programs that are focused on improving the quality of healthcare and become stakeholders and partners with government programs.
Bob Meinzer
Senior Director, National CME
New Jersey Academy of Family Physicians
Trenton, N.J.

“No Talking Allowed”

Regarding the Accreditation Council for CME's prohibition of commercial supporters' content review (“No Talking Allowed,” December 2007): What this will mean, naturally, is that purified CME will take longer to produce and providers will be compelled to invest far more resources into the validation and editorial accuracy functions. While one can understand fully the aspiration of creating CME that is as pristine and as free of bias as possible, it does appear to this writer that common sense has clearly left the building.
Neil H. Gray
Managing Partner
Healthcare Trends & Strategies LLC
Bridgewater, N.J.

I think Murray [Kopelow, MD, chief executive, Accreditation Council for CME] goes too far when he says: “It is absolutely essential that [CME content] validation not be performed by a commercial interest” [“No Talking Allowed,” December 2007].

It seems to me perfectly appropriate for a provider, or a faculty member, to submit specific questions regarding data not included in the labeling to a commercial supporter or another commercial interest's medical department through the standard channel that any physician can use in a request for information. This does not take the provider off the hook for verification of content accuracy, and it's no different from consulting any source for documentation. To my knowledge, this is not prohibited by the change in rules since it is not a direct request from the accredited provider to the grantor for validation.
Lewis A. Miller
Principal, WentzMiller & Associates
Darien, Conn.

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