WHY IS IT that within the CME enterprise there remain small pockets of individuals and organizations that continue to skirt established guidelines and regulations? While most CME planners, developers, and providers, whether accredited or not, are in compliance, others, despite the best of training efforts, continue to bend and break the rules.

Factors that contribute to noncompliance include lack of knowledge, misunderstanding, misinterpretation, or in the worst case, deliberate disregard for proper procedures. It is the latter behavior that finds its way into the negative headlines and fuels the fire of those who criticize CME. Those who do comply find themselves subject to the broad-brush view that CME is inherently mismanaged. The bad press is then followed by the inevitable next round of regulation designed to fix the problems.

The disregard of standards and rules of governance in any organization or social structure yields only short-term success. The violators are soon detected and ultimately pay a severe price: loss of trust, confidence, relationships, and business. Those who fund CME and those who develop and deliver content simply cannot be associated with those who place both reputation and community standing at risk.

While CME processes must be flexible and sensitive to a diverse and changing environment, deliberate and knowing disregard of accepted norms produces a dysfunctional and disordered system that is destructive to the whole.

Practice What You Preach

We should also be concerned about the effects of impropriety on those new to the CME profession, those who represent the future of CME. It seems to be blatantly improper on one hand for CME veterans to instruct newcomers in processes and procedures for compliant CME and then revert to inappropriate behavior. Those who set such an example do a disservice to the entire profession and certainly to those for whom they should be mentors and role models. It may be impossible to achieve fully compliant CME in the presence of an ongoing “exploit the loopholes” mentality.

By sending the wrong message to entry-level CME personnel, we perpetuate an atmosphere of negativity rather than one of growth and improvement. It is important for those who lead the decision process in CME to take their responsibility for compliant behavior seriously. There is an obligation not only to those who are in the beginning phase of their careers but also to the profession as a whole.

Choose Your Associates Wisely

Sending out the right message and instructing co-workers and colleagues can only improve the system for all. Appropriate, ongoing education and peer pressure from colleagues can address and resolve many, but not all, problems stemming from blatant violations. Such positive corrective efforts must be encouraged and strengthened. However, the ultimate sanction for those who persist in circumventing the rules is the loss of business opportunities and the contacts so important to success. Individuals and organizations dedicated to compliant and quality CME should and — I believe will — look elsewhere for business partners.

Sadly, the time, effort, and money used to identify and confront those who shun the rules detracts from CME's progress. If that energy were redirected to improving the educational process, the benefits of CME would increase dramatically.

The time has come to rededicate ourselves to providing compliant CME activities built upon a foundation of quality, patient-centered content.

Robert F. Orsetti is assistant vice president, continuing education, University of Medicine and Dentistry of New Jersey in Newark. Orsetti, a 24-year CME veteran, is a member of the AMA's National Task Force on CME Provider/Industry Collaboration. Contact him at (973) 972-8377 or send e-mail to orsettrf@umdnj.edu. For more of his columns, visit mm.meetingsnet.com.