As I read the splashy blue advertisement on the front page of USA Today's “Money” section, an important continuing medical education question arose.

Stephen Lewis

Appearing as it did beneath the top story about Apple's market capitalization outpacing Microsoft, the ad gave me pause. Maybe it was the fact that this was, after all, the Money section. Maybe it was because a hospital had paid for the message. Or maybe it was the ad's size — it took up the entire bottom portion of the page.

Whatever it was, the ad caught my eye. In bold fashion, it announced, “We regrow bone. Yes, you read that right.” Next to the headline was a simple logo and name: Cleveland Clinic.

Knowing that Cleveland Clinic is a not-for-profit with a respected CME program, I started with a simple question: If a not-for-profit organization pays big money to advertise healthcare services, isn't it selling something? After all, isn't that the point of marketing and advertising?

The CME Connection

The question is relevant to CME for three important reasons.

First, a couple of CME grant funders have made a business decision to provide grants only to “not-for-profits.” The logic is that a profit motive should be absent in CME. But why would a not-for-profit such as Cleveland Clinic spend so much money to attract, well, more market share?

Second, the Accreditation Council for CME does not allow “commercial interests” to participate in the development of CME. Defined as “any entity producing, marketing, reselling, or distributing healthcare goods or services consumed by, or used on, patients,” commercial interests must be independent from CME management.

But how is a pharmaceutical company that runs direct-to-consumer ads different from a $5 billion not-for-profit hospital that runs direct-to-consumer ads? Don't they both have a profit motive?

The third, and perhaps most important, consideration: U.S. hospitals now spend more on advertising than pharmaceutical manufacturers spend on CME grants. Yes, you read that right. In 2008, U.S. hospitals spent $1.23 billion in advertising dollars. In the same year, pharmaceutical and all other commercial interests spent $1.03 billion on CME grants.

Despite how the statistics may look, perhaps our CME funding focus emphasizes all the wrong stuff. Producing innovative, high-quality education requires funding, whether it's from a hospital administrator's budget or a CME grant to a university or medical education company.

Our focus on funding and company tax status has distracted us from the core CME issue: outcomes. Which leads me to my last CME question.

Is it better to focus CME funding around educational results or the type of organizations that produce them?

Stephen M. Lewis, MA, CCMEP, is president of Littleton, Colo.-based Global Education Group. He can be reached at slewis@globaleducationgroup.com.

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