SOME CME PROFESSIONALS have suggested that continuing education speakers should be disqualified based on the perception that their relations with commercial supporters constitute a conflict of interest. Now the difficult-to-measure concept of perception is being used to determine the appropriateness of facilities and locations for CE programs. Some pharmaceutical firms' attorneys are banning certain sites for CME events. In some companies, top-rated hotels and conference locations, such as Aspen and Palm Springs, are considered to be off limits for education. The Caribbean and other off-shore locations are really taboo. These policies apply to any type of educational event, whether the meeting is put on by the company itself, or the firm is providing commercial support to an accredited provider for CME.

Those who crafted current CME policies never intended the content- and process-focused guidelines to be barometers for meeting site choices. Skilled meeting planners can negotiate rates at desirable sites that are comparable to those offered by lesser venues. Properly planned CME content presented in an exotic location will have the same positive impact it would in a less attractive spot. In the interest of making CME the best it can be, have we engaged in overkill?

All Sites Created Equal

Current CME guidelines contain no references to educational venues. And for good reason. Unlike content, faculty credentials, commercial support, medical evidence, off-label discussions, fraud and abuse, recreation, and the like, all educational sites are created equal, at least in regulatory terms.

It is reasonable for most of us when on vacation or traveling for business or pleasure to visit and stay at the best locations our budgets allow. Why then are physicians, who under current codes are paying for their accommodations, held to a different standard? When away from home and medical practice, physicians may prefer a top-quality location. First-rate content, not location, should guide the physician's CME choice — and activity planners and supporters should be free to offer both.

Even those who argue that ancillary expenses incurred at more upscale locations add to a program's cost — and ultimately to the cost of medications — would surely admit that on a per-event percentage basis, the increase is small. On a national basis as a contributor to drug pricing, it is miniscule.

Regulate What Matters

So we return to the concept of perception. For some reason, meeting location is portrayed as yet another in the long list of CME ills. Is there any reason to believe that somehow the CME experience will be magically improved, patients better served, and drug costs reduced, if the choice of locations for CME is confined within a straitjacket? Not likely. Like many contributors to social well-being and the public health, CME will advance, improve, and grow only within the context of free expression of ideas by qualified presenters on their choice of turf.

Those who regulate CME, whether nationally or within supporting companies, would make more valuable use of their time and contribute more substantially to physician knowledge and performance by focusing on good science; credible faculty; independent, balanced, and unbiased programs; and measurable outcomes. Location is not the culprit.

Robert F. Orsetti is assistant vice president, continuing education, University of Medicine & Dentistry of New Jersey in Newark. Orsetti, a 24-year CME veteran, is a member of the AMA's National Task Force on CME Provider/Industry Collaboration. Contact him at (973) 972-8377 or send email to For more of his columns, visit