Industry-Funded CME activities continue to focus on arming physicians with the latest scientific research data regarding novel, often expensive, diagnostic and treatment approaches. However, physicians may fail to translate that information into clinical practice if hospital regulations or patients' lack of access to facilities present barriers. Furthermore, the newest drugs are not always the most beneficial for patients, especially if those patients are uninsured or their insurance companies won't cover the cost. In fact, in our experience, one of the most common physician-reported barriers to behavioral change is lack of reimbursement from insurers.

The Accreditation Council for CME's new accreditation criteria encourage providers to implement educational strategies that will address these physician barriers to change. The criteria also ask providers to identify factors outside their control that affect patient outcomes, and they emphasize increased collaboration among other stakeholders. Perhaps, if there were better collaboration among health insurers, patient advocacy groups, and CME providers, some of the environmental barriers physicians face could be eliminated altogether. More can and should be done by providers to bring these organizations into CME.

Partner With Patient Groups

Patient advocacy groups traditionally raise awareness about important issues; they spur research, education, and patient outreach for a variety of diseases and emerging health concerns. Additionally, these organizations can have a substantial impact on overall population health outcomes by providing links to support services that assist patients with medical bills, facilitate communication with physicians, and lobby for improvements in care. More important, advocacy groups have the potential to help CME providers identify specific needs of the patient populations they serve. Partnerships with these organizations will enable the medical education community to do the following:

• Participate more fully in determining community-based patient issues and implement strategies that best address these concerns.

• Gather data that addresses patient needs, e.g., the impact of socioeconomic and cultural issues on physicians' ability to successfully manage and treat a particular disease state.

• Clarify how treatment guidelines can be tailored to specific healthcare settings and patient populations.

Involve Insurance Companies

Based on our experience, the historical perspective that health insurance companies offer regarding treatment modalities, outcomes, and management trends has a direct correlation with overall patient health status. According to ACCME's definition, these entities are not considered to be commercial interests, allowing providers to contemplate optimal approaches to involve these stakeholders in the CME process. Here are some strategies to consider:

• Collaborate with insurance companies on activities that address physician barriers to using the most appropriate drugs and diagnostic procedures that improve patient care.

• Request support for CME activities that address insurance-related physician barriers to treating patients according to standards of care.

It's time that CME providers start thinking outside the box. All of us are patients first and foremost. If we start by understanding the needs of the complex patient populations served by the physicians we educate, we can design activities that have the maximum benefit for all stakeholders and improve healthcare for everyone.

Nathalie Harden, manager, CME and compliance, Applied Clinical Education, New York, has more than 10 years' experience in academic medicine and medical education. Contact her at nathalie_harden@hotmail.com. Ann C. Lichti, assistant CME director, Veritas Institute for Medical Education Inc., Hasbrouck Heights, N.J., has four years' CE experience. Contact her at justann@mindspring.com. The opinions expressed are those of the authors and do not constitute the views of Applied Clinical Education or Veritas Institute for Medical Education Inc.