MEDIA FOCUS ON healthcare costs, quality issues, professional competence, and scrutiny of pharma's role in CME, together with the recent proliferation of rules and guidelines, make it all too clear that we must move beyond just providing CME credit.

Harvard Business School professor John Kotter says that the best way to begin to create a change is to establish a sense of urgency. But while you know just how urgent the need is to move CME into its true role of facilitating learning and enhancing professional development, your department — and your parent organization — may not. Here are three specific things your office can do to help your parent organization wake up and smell the coffee.

1. Reengineer your CME office

   This is a big job, but it can be done if your office and your organization's leadership work together to assess what you're doing, and what you could — and maybe should — be doing. Once you figure out the current lay of the land and where you want to go, you can develop a new business model, new staffing patterns, and the sources of revenue that will take you there. But you can't do it without buy-in from your leaders, especially if you need additional resources or policy support to carry out your primary functions. And don't forget to look at who benefits from your office's services — and who pays.

2. Offer regulatory protection

   You might also be able to assist your parent organization in alerting staff and faculty to the recent proliferation of regulatory requirements that govern our CME offices and the activities of our parent organizations, whether they be hospitals, specialty societies, medical schools, and publishing companies, or advertising agencies, communication companies, and government organizations. Faculty need to know that their actions could lead to legal or regulatory problems for the institutions in which we work. Not only can we help to educate others, we can also take a more active role in assuring regulatory compliance throughout the organization.

3. You are the solution

   Don't let your CME offices' main functions marginalize you from the primary mission of the larger organization. One way to change this, especially for CME organizations that are embedded within healthcare provider groups, is to initiate activities that are more aligned with the provision of high-quality, cost-effective healthcare. Working across the continuum of medical education, helping to reduce unnecessary variation in practice and the costs of healthcare delivery, enhancing physician performance, and reducing medical errors are just a few of the areas where our CME expertise can contribute in a significant way to the larger mission of patient care. These issues are already urgent in the eyes of those who lead our parent organizations. Let them know that we can be a critical part of the solution to these problems.

Joseph S. Green, PhD, is associate consulting professor, Department of Community and Family Medicine and associate dean of CME, Duke Office of CME, Duke University Medical School, Durham, N.C.; James C. Leist, EdD, is co-director, faculty development, interim director, Alliance Center for Learning and Change and associate consulting professor, Department of Community and Family Medicine, Duke University Medical School; Robert E. Kristofco, MSW, is associate professor and director, Division of CME, University of Alabama School of Medicine, Birmingham, Ala.

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