The title of this column comes from the now-defunct comic strip Pogo. The character named Pogo lived in a swamp, and the strip documented the adventures of the swamp's citizenry who, not surprisingly, encountered many of the same problems as those of us who live on putative higher ground. Pogo often encountered characters who tried to do the right thing, but without bothering to check with those impacted by their actions.
Here on the high ground, we've all heard of well-intentioned doctors who do not listen to their patients, or who make decisions without bothering to consider their patients' needs and wishes. I wonder if we as CME providers might be guilty of these same kinds of insensitivities. More specifically, there have been lots of e-mails among SACME (Society for Academic CME) members concerning some drug companies' interactions with CME providers. The things these companies wanted to do when funding CME clearly run counter to Accreditation Council for CME, Pharmaceutical Research and Manufacturers of America, and American Medical Association policies, and so they should not be done. But that's not the problem. The problem is that we providers criticize the companies' proposals without asking them about their expectations, their understanding of the various guidelines, and so on. If we asked those questions, we could then propose to teach them whatever they needed so they wouldn't risk running afoul of us or our accreditation agency or any other group that had guidelines on such things. Instead, how did we handle this issue? As Pogo observed, we have met the enemy and they is us.
Industry's Learning Needs
From an adult-learning perspective, the question here is simple: What are the learning needs of industry people such that we might help them avoid such problems?Though the question is simply stated, answering it requires that we take a step back from our perspectives as CME providers and look instead at the companies' goals and how those goals can be addressed within the current CME environment.
How do we providers do such things?First, we need to engage industry in ways that recognize they both share needs with us and have needs that are independent of what we do. Our Canadian colleagues have done this for quite a while by establishing programs where members of industry spend protracted periods of time working collaboratively with CME providers within the providers'offices. This has happened, I believe, both at the University of Toronto and McMaster University.
Walk a Mile in Their Moccasins
Second, it should be possible to have people from the CME community work with pharmaceutical companies in their offices to help address their needs. Such collaborative activities might benefit both sides since it will be easier for all to see how their perspectives relate to those of the other group.
Finally, activities like the American Medical Association's Conference on CME Provider/Industry Collaboration might be extended to include short courses on physician learning and courses run by one group for the benefit of the other. CME providers might run sessions describing for representatives and others the various guidelines on how industry might interact with physicians, and industry might offer activities for CME providers helping them to understand pharmaceutical marketing. These activities should benefit each group by increasing the abilities of those involved to understand the perspectives and needs of the other group. This will reduce the likelihood that Pogo would be saying we have met the enemy and they is us and instead he would say: We have met the enemy and they ain't us at all.
Henry B. Slotnick, PhD, PhD, professor of neuroscience at the University of North Dakota in Grand Forks, conducts research on how physicians learn. He has been recognized by the Alliance for CME with several awards for his contributions to CME. Send your questions or ideas to slotnick@medicine.nodak.edu.
