Letter to the Editor: Reflections on the Alliance for CME

Thank you for your perceptive and energetic review of the ACME meeting. You captured many of the flavors and energies that were felt by many in the room, including very ancient ones like me, as well as the many young women and men who represent the different elements of ACME.

Having attended the first meeting in 1976, attended by 75 physicians (90 percent of whom were male), plus Lew Miller [principal, Wentz Miller & Associates. LLC], I was particularly sensitive to the re-imagining of ACME, which has taken place several times since then, now reaching a very large spread of job descriptions, trainings, for-profits, medical schools, exhibitors, and a sprinkling of “academic journalists.”

I believe the most important “new direction” is the merging of professionals providing and receiving CME. We can call it “CNE” for nurses, and “CDE” for dentists—or even “CHE,” for health professionals, (except for the likelihood that an “A” would be put in front, just for fun!)

While it was not invented by ACME, it is transformingly true and central that healthcare is provided by a range of job descriptions; nurses outnumber physicians by at least five to one in the U.S., and there are many “special tracks” in nursing, from less-than-bachelors, to “advance practice,” to PhDs. Psychology (long distinguishable from psychiatry) also has legions of sub-disciplines, from social workers, pharmacists, and first-responders, to health information technology workers.

The Institute of Medicine, and most large healthcare organizations, have as directors many non-MDs, including the above-listed professions. Even the American Medical Association, which is in business to serve physicians, has some spread (despite some members who scream bloody murder at the suggestion that a less-trained person could do some healthcare-related tasks well, possibly even better than MDs.

It’s good that ACME will join in the pan-healthcare missions that address the post-graduation years, such a longer fraction of our professional lives than the years in undergraduate and graduate medical education. The new age in continuing professional development will do well by capturing many of the habits and methods learned through ACME.
Richard N. Pierson Jr., MD, FACP

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