Some believe that CME stakeholders belong in different camps—that academic medical centers and medical societies are inherently different than medical education companies. The simple truth is that we all work in medical education businesses, whatever our organizational model. Consider the following examples.

The Cleveland Clinic: Its CME officehas a good reputation and recently produced an excellent study showing the lack of bias in CME. But the CME team is a small education business unit that is part of a very large company incorporated in Ohio.
The Cleveland Clinic earns $5 billion in annual revenues and recently doubled its advertising budget. According to a federal tax filing, the Cleveland Clinic spent $35 million in advertising and promotion to grow its market share in 2008. And business is booming. As a company, the Cleveland Clinic is adding operations in Abu Dhabi, Austria, and Singapore. Newsweek magazine once called the Clinic “a hospital trying to be a Toyota factory.”

Universities and associations? Johns Hopkins is incorporated in Maryland. The American Academy of Neurology is a Minnesota business. All universities, hospitals, associations, and other medical education companies register their businesses in various states.

A key goal of any business, whatever its federal tax status, is to operate profitably so it can continue to keep the doors open and do good things. As a wise association executive once told me, “Not-for-profit does not mean we are a ‘for-loss’ organization.”

In order to grow, all businesses focus on some type of marketing. That’s why a representative from Virginia Commonwealth University is delivering a session at a 2011 American Hospital Association meeting to help make attendees “valuable … to your organization by applying your
marketing skills to support wellness goals and help manage chronic illnesses—through ‘social marketing.’”

All businesses require revenue and market share to operate successfully. Our CME businesses at hospitals, medical schools, societies, and other medical education companies are no different.

Whether our budgets come from a hospital administrator, dean, society education committee, or an education grant from industry, the reality is that it takes money to pay for high-quality CME. We must face a simple fact: Without funding from some budget, none of us would have a job in this wonderful business of CME.

Of course there are differences in how each of us approaches our education business. Some of us are more efficient than others. Some of us have closer ties than others with faculty, attendees, or even patients. But we all abide by the same set of accreditation and other requirements that manage how the CME business operates.

The CME enterprise imitates life. We all are judged by the company we keep.

Stephen M. Lewis, MA, CCMEP, is president of Littleton, Colo.–based Global Education Group. He can be reached at


More Stephen Lewis columns
Is CEJA Becoming an Oxymoron?
Ringing In a New Era for CME
REMS: A New Trajectory for CME?
Is it Time to Thank the ACCME?"