What's hot in the medical conference industry

WILL NEW COMPETENCY RULES CHANGE CME? "I think this has the potential to shake up the CME industry," says Herbert Waxman, MD, senior vice president, education, American College of Physicians-American Society of Internal Medicine, Philadelphia. Waxman is referring not only to the huge changes in the recertification process that are now evolving, but also to a confluence of numerous forces that are pushing CME in new directions for 2001 and beyond. First, the background.

From Certification to Competence The whole medical field, including the CME community, is under increasing public scrutiny. The public, more empowered and educated about health care than ever before, is demanding greater accountability from the medical profession. In March 2000, the American Board of Medical Specialties, which governs medical boards, responded to those concerns by initiating changes to the recertification process. Rather than taking exams only every so many years, physicians now have to prove a "maintenance of competence" throughout their careers and show a commitment to lifelong learning and improvement in their practices. Among other requirements, physicians have to demonstrate not only their medical knowledge, but their skills in areas such as patient communication. And they must evaluate their performance in their practices and show improvement.

This summer, the American Board of Internal Medicine took the leap, becoming the first specialty board to introduce a new recertification process based on the ABIM guidelines. Under the "continuous professional development" or CPD process, as it is called, physicians, instead of taking a recertification exam every 10 years to maintain their board-certified status, have to begin their recertification efforts in the fourth year of their cycle, and conduct periodic self-assessment modules. The new system is being phased in and will be completely in place by 2004. The ABIM's CPD process does not require CME for recertification, but its old one didn't either. However, the ABIM's move has far-reaching implications for the CME community.

Who Should Give Credit? One of the first issues to resolve is: Who will provide physicians with the education they need to successfully navigate the new CPD system?

Waxman, with the American College of Physicians-American Society of Internal Medicine, and other CME leaders, say the speciality societies should be responsible for educating their members. "We know the education business the best," Waxman says. The ACP-ASIM, whose members are complaining vociferously about the CPD system, seeing it as another intrusion into their already too-busy lives, has taken a proactive stance, agreeing to the formation of a joint committee with the ABIM to ensure that the board addresses those physician concerns. And, responding to member requests, the ACP-ASIM agreed to sponsor Category 1 credit for the educational preparation candidates undertook.

Sounding a cautionary note, Marcia Jackson, PhD, senior associate executive vice president, education for the American College of Cardiology, Bethesda, Md., says, "In the field of internal medicine, there's a history of keeping the activities of the boards and the specialty societies separate. Even with this history, there's confusion, because members tend to assume that the ACC is responsible for the board's actions. At this point, the ACC will do everything we can to help members who are going through the CPD program, including providing tools and educational materials." She adds that the ACC is "continuing a dialogue with the ABIM as to how boards can work collaboratively with the societies as the planning for the CPD program evolves."

New Visions of CME It's that kind of proactive, collaborative action that CME providers should take, says Bruce Bellande, PhD, executive director, Alliance for CME. It remains to be seen how the other 23 boards - 11 of which do require CME for recertification - will respond to ABMS's mandate to assess continuous competence, Bellande says, but CME providers should not wait to take action. "CME providers are closest to the physicians in practice who are going to seek [recertification]. It's incumbent on providers to not only understand what's asked of them, but then to design and develop activities to help physicians maintain their certification."

Bellande, Waxman, and other CME leaders see the ABMS's maintenance of competence initiative as one of many forces pushing the CME community to reinvent medical education. A variety of studies have shown that traditional CME lecture programs are not effective in changing physician behavior - and it is those changes in practice that physicians must demonstrate under the new regulations.

State licensing boards and hospital credentialing committees also want proof that CME is relevant. At its annual meetings, the ACP-ASIM is offering small group sessions on clinical and communication skills. "We're depending less and less with each annual session on large lecture halls packed with people," Waxman says. "Change is not something we should be intimidated by," adds Bellande. "This is a wonderful opportunity to demonstrate that CME does make a difference, and therefore should be part of the future system of maintenance of competence. We have to develop systems to measure and report its effectiveness."

PGI CREATES MED-ED UNIT Responding to the enormous number of product launches projected for the pharmaceutical industry over the next five years, PGI Inc., the event and meeting management company, has announced a new business unit called PGI MedCom to develop CME programs for pharmaceutical company clients. To kick-start the business, PGI has hired Lisa Bitetto and Christina Culbert as vice presidents, account services. Working out of PGI's New York City office, Bitetto and Culbert will create program content, while PGI, headquartered in Arlington, Va., will provide meeting logistics services, offering clients one-stop-shopping.

MedCom has no plans to become accredited, but will offer accredited programs through Accreditation Council for CME-accredited providers. Bitetto stresses that unlike some medical communications companies, MedCom is not affiliated with any promotional or advertising agency. For more information, visit www.pgi.com.

If you're a member of the Alliance for CME, you no longer have to fill out those pesky MM subscription cards. Under a new arrangement, Alliance members will automatically receive subscriptions to MM, and have their subscriptions renewed. Your name will be used only for your subscription - MM will not release your name for any other purpose.

If you wish to decline this offer, please send your name and address, via e-mail, fax, or snail mail, to: Georgi Mueller - Medical Meetings - 43L Nason Street Maynard, MA 01754 - Fax: (978) 897-6824 - e-mail: gmueller@aip.com

Via the CME listerv we asked CME providers: What is the biggest challenge or change facing the CME community in 2001? Here is a sample of the responses.

* "I am always trying to think of new and unique methods for carrying out adult education. I would like to get information about alternative methods of adult education other than the traditional lecture format. This represents my biggest challenge and my most important goal."

- Alan H. Goldberg, MD, PhD, professor of anesthesiology, Medical College of Wisconsin, Milwaukee

* "Rising audiovisual needs and subsequently audiovisual expenses, and costs of technicians needed in each session room."

- Charlotte Donn, director of administration and publications, Society of Laparoendoscopic Surgeons, Miami

* "A challenge I perceive for the CME community in 2001 is identifying and taking advantage of funding opportunities that previously may not have been considered. As resources shrink, the ability to seek and utilize new funding sources will be critical in order for us to continue to accomplish our priorities in an effective manner. New partnerships will have to be forged and new territory explored."

- Melinda Steele, director, CME, Texas Tech University Health Sciences Center, Lubbock

* "I believe the shift to outcomes-based CME makes sense, but how do we afford it? I am at a community hospital. The data that is presented in department meetings to doctors is highly disputed by them (garbage in/garbage out theory). And the docs are right most of the time. So relying on my internal quality management department to provide data that is useful is not working. I don't have the time or resources to do mailings three to six months post-lecture to ask a subjective question: Has your practice changed? I can't measure outpatient clinical changes (better asthma management, better diabetes management, etc.) Does that mean it should not be taught because I can't measure it?

"Funding is being cut by hospitals for CME at a rapid rate, forcing departments to turn to pharmaceutical companies more and more. The pharmaceuticals want a better return on investment. They are demanding sign-in sheets. Greater access to doctors. And in general they push the limits of the commercial support guidelines. A headache for many CME departments."

- Debi Lanning, manager, medical education Bayfront-St. Anthony's Health Care, St. Petersburg, Fla.