Missed Opportunity

Dear Editor: I appreciate your mentioning the activity of the Specialty Society Provider Section in your editorial in the March/April 2003 issue of Medical Meetings [page 8]. I just wanted to clarify that Murray [Kopelow, MD, Chief Executive, Accreditation Council for CME] and I had discussed the type of role he and his staff would play at the meeting prior to the session. I asked Murray not to address the questions posed. My goal was to give the group the opportunity to list all of the possible questions they had in a brainstorming session without time being taken out for discussion or reply.

Simply speaking, I wanted to foster free-flow expression of questions and concerns in this session. I explained to the group at the time that I would share all the questions and concerns with Murray and his staff, and Murray agreed to provide responses to these on the ACCME Web site (which he did). There may have been other ways to do this, but I think this process generated some excellent questions and concerns that were not clearly stated in other sessions. From your article, it might be perceived that the ACCME was withholding info, and I just want to assure you that this was not the case.
Damon K. Marquis, MA, MS
Director of Education and Research
American Academy of Physical
Medicine and Rehabilitation

Dear Editor: Your editorial in the March/April 2003 issue of Medical Meetings caught my eye. Actually, it also captured my voice, as I found myself commenting on the editorial to my CME coordinator. I, too, felt frustrated after attending the Alliance for CME meeting this year for just the reasons you list: lack of opportunity for Q&A and dismay at the heavy-handedness of Murray Kopelow and other presenters (they certainly weren't discussion leaders!) in cutting off discussion.

Additionally (while I'm editorializing!), I felt frustrated that there were not more physicians actually presenting some of the lectures. I really would like to hear from physicians about teaching physicians at this sort of national meeting.
Darla Grossman, MD
Director, CME
St. Mary's Medical Center
Evansville, Ind.

Dear Editor: Your coverage of the Alliance for CME meeting in Dallas was right on the mark. I truly admire your taking on Murray Kopelow, MD. The ACME meeting was such a wonderful opportunity to really hear what we all had to say, and instead they took the low road and asked that we address the Standards in written form. Also, hats off to [Executive Editor] Sue Pelletier. The two of you make a great team, and it certainly shows in every issue of Medical Meetings.
Name withheld upon request

Dear Editor: Your March/April 2003 editorial “Missed Opportunity,” suggested that the ACCME's draft Standards for Commercial Support were “released … to gather feedback at the Alliance for CME annual conference” and that “attendees were left feeling frustrated and infuriated.”

While the 2003 Alliance meeting provided a wonderful forum for receiving feedback on the Standards and other issues, it was not the ACCME's mechanism for obtaining comments. Rather, as indicated in our January 14 Call for Comment, feedback was due to the ACCME by March 15, and a convenient e-mail vehicle was provided. In addition, I was gratified to see ongoing discussion of the Standards taking place throughout each day of the meeting — among providers, other CME professionals, and commercial supporters — and regret that any attendees were unable to reconcile their queries or concerns while at the meeting.

The ACCME used its time at the Alliance meeting to both address the draft Standards as well as honor longstanding commitments to learners to address other issues (the future of CME, new expectations of CME, and interpretation of compliance issues) in our scheduled sessions. In addition, to ensure everyone understood what was being proposed in the draft Standards for Commercial Support, each of our agendas at the Alliance meeting included this issue. After that meeting, and in another attempt to ensure that commercial supporters understood our intentions, the ACCME discussed the draft in detail with representatives of industry through conversations with Merck, Pfizer, and Eli Lilly. In addition, we participated in a telephone meeting convened by the Pharmaceutical Research and Manufacturers of America that included 30 representatives. As promised at the Alliance meeting, we posted some frequently asked questions on www.accme.org, in order to address the issues that arose at the Specialty Society Special Interest Group's session.

Our Call for Comment on the draft Standards for Commercial Support has provided us with thoughtful observations and suggestions that reflect the providers' and commercial supporters' accurate understanding of what we are proposing. We employed the written medium as the mechanism by which to receive comments to ensure that all feedback was accurately captured and to afford everyone equal access to the system.

As has been the case with all such endeavors of the ACCME, future iterations of the Standards of Commercial Support will include examples, discussion, and explanations on how to implement the requirements.
Murray Kopelow, MD
Chief Executive
Accreditation Council for Continuing
Medical Education

Mission Impossible

Dear Editor: I thought this article [March/April, page 27] was very well done. It addressed all the concerns that were expressed by my organization, and I found the answers from Murray [Kopelow, MD, Chief Executive, ACCME] and Norm [Kahn Jr., MD, chair of the ACCME's task force on the Standards for Commercial Support] to be helpful. Nice job!
Marcia Jackson, PhD
Division Vice President, Education
American College of Cardiology
Bethesda, Md.

Dear Editor: I just read your piece in the March/April issue. I think you were admirably objective and restrained. Have you talked with any provider of CME who thinks these changes in the Standards [for Commercial Support] are a good idea?
Kevin Bunnell, EdD
CME consultant
Boulder, Colo.

Editor's Note: Yes, we did find one provider who is in favor of the revised Standards. For her opinion, Bunnell's response to the ACCME, and other comments, see “Gag Rules?” on page 24.

Educators, Get Real!

Dear Editor: Good article. But I must make one comment aimed at the provider who was quoted as saying: “If I want to change things, I have to step up to the plate. I just wish today's leaders would reach out to me.”

My advice? Don't wait! As someone who is deeply involved in the trenches, and with no PhD or MD after my name, I have found that I can be just as effective as anyone else. The trick is to know what you want to accomplish and go out and do it.

I have been very active in our industry. I am involved with the Alliance for CME, where I helped to form one of the Provider groups (the Medical Education and Communication Company Alliance), with the ACCME (as a surveyor), and as one of the founders of the North American Association of Medical Education and Communication Companies (NAAMECC). I would not have been at all involved if I waited for someone to “reach out to me.”

Believe me, the “leaders” are looking for people to step forward! Don't be bashful! Volunteer to get involved. All too often a call goes out for people to volunteer, and no one answers that call. So, don't worry about initials. Don't wait to be asked. If you have something to contribute … offer it!
Mark H. Schaffer, EdM
Vice President, CME
Thomson Professional Postgraduate
Secaucus, N.J.

Dear Editor: I enjoyed the frankness of your articles this month. Your point about the reality of the work in the trenches versus the policy makers is so true. Keep up this type of dialogue.
Peggy Hamernik
Continuing Medical
Education Coordinator
Evergreen Healthcare
Kirkland, Wash.

Goose and the Gander

Dear Editor: I read your “Second Opinion: The Goose and the Gander” [March/April, page 196] and “Checking Up on Docs” [page 32] with interest. I was curious about the “Contract for Change” that the Alliance for CME included on their conference evaluation form.

Can you provide a contact, or explanation of just how the “contract for change” was worded/posed and how it worked? Thanks!
Kristin A. Summers, PhDManager,
Professional Education Programs
Professional Resource Center
National Multiple Sclerosis Society
New York

Editor's Note: The Alliance for CME's Contract for Change asked attendees to answer the following questions. Response options ranged from strongly agree to strongly disagree.

The 2003 annual conference …

  • Made me aware of changes I need to make in my current practice.

  • Encouraged me to commit to making such changes.

  • Showed me ways to implement those changes.

  • Identified barriers I might encounter when making such changes.

  • Pointed out how changes I make may directly enhance CME offerings.

  • Highlighted how changes I make may indirectly improve physicians' practice.

  • Suggested how changes I make may indirectly result in enhanced individual patient health.

  • Instructed me on how changes I make may indirectly lead to better aggregate population health.

  • As a result of the 2003 annual conference, one concrete, measurable change I'll make in my CME practice is (participants filled in the answer).

The Alliance also asked for respondents e-mail addresses, to send a follow-up survey regarding the proposed change.