CME's Voice in Washington

Dear Editor: Your plea for the “CME industry to form a government advocacy task force” [“CME's Voice in Washington,” March/April 2006] is indeed important and timely. Two years ago the Alliance for Continuing Medical Education did indeed establish an advocacy task force, with the charge of recommending to the Alliance board of directors an advocacy program conforming to the Alliance's mission of “advocating for CME and the profession.” The task force developed processes to identify and prioritize issues of importance to the profession, along with a process to craft position statements for review, approval, and dissemination to Alliance members, the CME profession, and the public. In addition, the task force's plan called for the establishment of communication strategies, including public relations campaigns.

The Alliance has used its advocacy process to craft and disseminate its position on CME certification, which is posted on the Alliance's Web site at The Alliance's advocacy program has been designed to be both proactive on issues of importance to the CME profession and reactive to adverse, unfavorable, or inaccurate findings and reports in the media. To complete the development phase of this endeavor, the Alliance for CME is seeking professional consultation with an expert in advocacy with the intent of finalizing and implementing a comprehensive, seamless, and efficient advocacy program.

It is important to note that the Alliance is a 501(c)3 not-for-profit association. In keeping with IRS regulations, the Alliance defines advocacy as a nonpolitical endeavor with the goal of promoting the best interest and public image of our members and the profession.

The Alliance commends you for your commitment to advocate for the CME profession. With your support and the support of other media representatives, along with CME professionals and stakeholder organizations, we will succeed in our efforts to advocate for the value and effectiveness of CME as a public good.
Harry A. Gallis, MD
Alliance for CME
Birmingham, Ala.

Dear Editor: You are right on! I agree that the CME community needs to mobilize into action and provide needed education on a variety of topics. The key here is to provide information regarding off-label uses. There is too much misunderstanding regarding products used in this manner. In addition, if patients are feeling better because of off-label uses, their comments should be provided to attorneys — who don't understand their uses either. I do believe reason can prevail if decision-makers are better informed, and CME content and grant acquisitions are controlled by accredited providers. If organizations, hospitals, and companies want to deliver certified CME activities, then they should become accredited providers through the Accreditation Council for CME system or the state medical societies. Why not convene a summit conference on this topic? You could invite the CME leadership represented by the Council of Medical Specialty Societies, the North American Association of Medical Education and Communication Cos., the Society for Academic CME, etc.
Jacqueline Parochka, EdD, FACME
Excellence in Continuing Education, Ltd.
Gurnee, Ill.

Dear Editor: I congratulate you for taking the initiative to stand up for the CME enterprise, and I offer our assistance and support. Please allow me to describe what we have already done to try to make a difference.

The Texas Academy of Family Physicians prepared the text of a letter sent to Senator Chuck Grassley [R-Iowa], chairman, Senate Finance Committee, by an Iowa family physician who knows the Senator personally. TAFP wrote the CEOs of all the major pharmaceutical companies, communicating our appreciation for their support of CME and expressing our commitment to developing CME in strict compliance with Accreditation Council for CME guidelines. We got one response. We met with and corresponded with Congressman Michael C. Burgess, MD, 26th District of Texas.

TAFP launched an information initiative to educate members about the impact of losing pharma support and how grant-supported CME can be fair, balanced, and free of commercial bias.

We have also created a number of initiatives to come up with a reasonable solution to the quagmire and unintended consequences caused by the Office of Inspector General's Compliance Program Guidance for Pharmaceutical Manufacturers. We corresponded with the OIG, pointing out the difference between CME and product education events. The TAFP board of directors approved a resolution to take to the American Academy of Family Physicians Congress of Delegates, suggesting ways for the Academy, individual pharma companies, and the Pharmaceutical Research and Manufacturers of America to work together. The resolution calls for the creation of an AAFP Commercial Support Strike Team to encourage commercial supporters and PhRMA to use the ACCME Standards for Commercial Support instead of the PhRMA Code when considering educational grants for CME; apply the PhRMA Code to company-sponsored product education events, not certified CME; establish a uniform, Web-based educational grant request process; and establish a process that results in truly unrestricted educational grants with CME providers responsible for all final topic and program decisions. Please note that the AAFP Congress of Delegates does not meet until September. They may or may not adapt our resolution.

Let me know what I can do to help. Your involvement, your voice, and your passion can make a difference.
James M. White
Executive Director
Texas Academy of Family Physicians
Austin, Texas

Dear Editor: Your recent “Checkup” column, “CME's Voice in Washington,” contains marching orders for all of us who care about the future of continuing medical education and continuing physician professional development in the U.S. We urgently need to become active advocates on behalf of first-rate CME. We need to aggressively combat the media headlines and other sources that scream “CME doesn't work,” or that most CME is tainted by industry, because these stories are believed by so many policymakers. Some of it is our own fault. We need to change the perception and tell a convincing story with facts — good CME does work, and practices do change for the good of quality patient care. Most practicing doctors will back us. This advocacy effort must be sustained and reach policymakers in Washington and in every statehouse in the country. Patients and society must be convinced that it is the responsibility of the entire healthcare system to share as partners in this knowledge mission. As the World Federation for Medical Education said in 2003: “Funding of CPD activities must be part of the expenses of the health care system.” Thanks for articulating the issue. I join you in asking how, when, and where we start?
Dennis K. Wentz, MD
Former Director, Division of CPPD
American Medical Association
WentzMiller & Associates
Avon, Colo.

Dear Editor: CME has been the professional responsibility of physicians since the time of Hippocrates. Keeping up — and periodically examining one's own practice in light of new knowledge — are necessary skills to be able to deliver high quality patient care. There is no doubt that those of us who are CME professionals need to do the same. We need to conduct ongoing research, review the evidence, and modify our practices accordingly. I believe that is where we are going, with the new emphasis on outcomes data that goes beyond a satisfaction index. And, in fact, the pharma industry is helping, perhaps under duress from the OIG, but nonetheless with reformation of its funding system and its new emphasis on effective outcomes measures.
Lewis A. Miller, MS
WentzMiller & Associates
Darien, Conn.

MM's the Tops

Dear Editor: I just wanted to compliment you on one of the best issues of Medical Meetings that I have ever read. It is outstanding and [much] of the credit goes to Sue [Pelletier, executive editor]. She did a fantastic job with all of her articles. They are incredibly helpful and valuable to the CME practitioner and to old folk like me who are trying to keep up and continue learning. Sue always does exceptional work, but this issue was the tops.

I really like your editorial [“CME's Voice in Washington”] as well. I agree that CME needs to be a more vocal presence in Washington, D.C., and internationally as well. I am very interested in your additional thoughts about an organized, concerted, and comprehensive effort to establish the benefits of CME provider/industry collaboration to the government. I do agree that this effort needs to avoid the various bureaucracies. That will be the toughest task. I would be very interested in helping facilitate such an initiative.

FYI, on a separate but related issue, I am working on a project for the Alliance for CME that relates to your point indirectly. It is an update of an Alliance CD prepared in 1999 for industry representatives on how to build effective relationships with CME providers. We are making a webcast which should be available this spring. Congratulations again on a great issue.
James C. Leist, EdD, FACME
Interim Director
Alliance Center for Learning and Change
Charlotte, N.C.

Outcomes, Level by Level

Dear Editor: Dr. Havens and I want to thank you for your recent Medical Meetings article based on our 2006 Alliance for CME annual conference presentation on outcomes [“Outcomes, Level by Level,” by Sue Pelletier, March/April 2006]. It is great that our model and examples can be disseminated to such a broad audience. And we truly appreciate your efforts to represent our presentation content thoughtfully and accurately. We'll look forward to future articles that address the challenges of effective CME planning and evaluation.
Philip Bellman, MPH
Training and Development Consultant
The Permanente Medical Group Physician
Education & Development
Oakland, Calif.