There's a big difference between certified CME and promotion. The problem is -- legislators and other stakeholders don't understand the distinction.
The CME enterprise could use a taste of its own medicine. Education, that is. Or perhaps we should label it honestly: marketing of independent, certified CME.
Despite consistent chatter about evidenced-based education and continuous improvement, we have failed to educate regulators and other key stakeholders about what CME is and what it is not.
The result? We have not demonstrated that evidence-based CME developed in accordance with Accreditation Council for CME standards and policies is, in fact, any different from marketing. Several recent articles, reports, and proposals confuse certified CME with pharmaceutical marketing or so-called “promotional education.”
The deductive syllogism goes like this:
Education is really just a marketing tool to provide kickbacks to physicians in exchange for increased prescription writing.
CME is education.
CME is a marketing tool.
Here's the irony: Pharmaceutical organizations, medical education companies, and other accredited providers have spent tens of millions of dollars deploying firewalls, independent grant review systems, and significantly improved measurements of educational outcomes. At the same time that CME quality is increasing, scrutiny of it grows more rapidly.
The confusion stems from terminology, continued practices, and false perceptions. For starters, there are a lot of marketing initiatives that are designed to “educate” a particular audience about a particular product. Held under names such as “Peer Discussion Groups” or “Thought Leader Exchanges” these persuasive activities are aligned with selling product, not knowledge.
Existing practices haven't helped distinguish CME from marketing, either. Only a handful of pharmaceutical organizations actually allocate budgets to medical education departments independent of marketing. Some industry CME teams just recently stopped managing both CME and promotional education initiatives.
Legislators aren't the only ones who are confused. Members of the medical profession also have trouble distinguishing between certified CME and marketing. In an April 16 Journal of the American Medical Association editorial, “Impugning the Integrity of Medical Silence: The Adverse Effects of Industry Influence,” Catherine D. DeAngelis, MD, MPH; and Phil B. Fontanarosa, MD, MBA, attack manipulation related to pharmaceutical clinical research practices as mischievous marketing. Instead of sticking to theme, they casually insert that “the direct influence of for-profit companies on education…has been well documented,” as if corporate promotion and certified CME were somehow linked.
Unfortunately, the JAMA editorial provides no evidence for its assertion against education and relies on one study conducted prior to 1990. But we can't blame the regulators or others for misperceptions. We can't expect them to analyze our needs assessments, grant review processes, and accreditation standards without some prodding. We have to own our reality and get the word out.
Stephen M. Lewis, MA, is president of the Institute for Continuing Healthcare Education in Philadelphia. Reach him at email@example.com.