The Case:
Long-Life Medical Center (an accredited provider), in partnership with the Consortium Against Addiction (a nonprofit community advocacy organization), planned a series of seminars to help clinicians address the issue of prescription drug abuse. In addition to addiction specialists, recovering addicts and their families were involved in planning the education and were invited to participate as faculty in the activities, which included case studies, workshops, and role-playing.

This is the first time LLMC has worked with “nontraditional” partners and faculty, and Addie Iction, LCM’s CME manager, was excited to be including patients and caregivers in the activity’s design and implementation.

Addie’s role included monitoring each seminar. Near the end of the first activity, the patient (Ned Narcanon, a former addict now in recovery) presented a moving story of how he manipulated clinicians to feed his addiction to pain medication. The participants were riveted by his passionate case presentation. Then Ned unexpectedly mentioned a specific pain management clinic and said that its medical director, Dr. Polly Pillpusher, was responsible for his addiction and that her treatment of him was negligent. This is not what Addie discussed with Ned and was not in the outline he provided to her to review.

Addie quickly scurried to call her education director to determine how to mitigate the damage.

Have Patience with Patients
What are the possible implications of Ned’s statements?

Overstreet: We live in a litigious society. The practitioner that Ned mentioned might be upset by the allegations, particularly since colleagues were in the audience.

Parochka: CME professionals can never be certain what presenters (clinicians or otherwise) will say or when they will say it. It’s best to take precautions to avoid these incidences if at all possible.

What precautions should providers take?

Overstreet: Because patients and other nonclinicians are not familiar with CME guidelines and best practices, education is key. All faculty should be provided with criteria for their content to ensure that it is balanced and evidence-based. Providers could also require speakers to sign an agreement attesting that they understand their responsibilities.

Parochka: In order to avoid surprises at the live event, Addie could have videotaped the patient presentations beforehand, had her education director review the content for balance and appropriateness, and had it edited accordingly. Patient presenters also should sign a release granting the provider permission to edit and use their videotaped comments during the actual CME activity.

Overstreet: Providers should also consider including a disclaimer that speakers have been instructed to provide fair and balanced information and that the faculty members are responsible for their content.

What could Addie do to resolve this situation?

Overstreet: Addie should talk with Ned as soon as possible to remind him of his obligations as a speaker. She could encourage him to talk directly with Dr. Pillpusher regarding his concerns and to apologize for the public statements. She should also carefully monitor evaluation forms and other feedback from participants to determine the learners’ level of concern (if any).

Parochka: This is likely going to take more than an apology to assuage the public embarrassment. CME professionals should memorize Murphy’s Law­—if something can go wrong, it will! Providers can protect themselves from this type of situation by offering patient presentations in pre-recorded formats ( i.e., DVD, CD-ROM). It’s easier to take steps to avoid these situations with thorough preplanning than it is to try to resolve them after the fact.

Karen Overstreet, EdD, RPh, FACME, CCMEP, is executive director, Lippincott CME Institute, Wolters Kluwer Health Medical Research, Blue Bell, Pa. Reach her at Karen.Overstreet@wolterskluwer.com.

Jacqueline Parochka, EdD, FACME, is president and CEO, Excellence in Continuing Education Ltd., Gurnee, Ill.; and partner, PTR Educational Consultants. Reach her at JacquelineParochka@comcast.net.