Responding to concerns expressed by the Federation of State Medical Boards about the increasing number of CME courses that teach alternative therapies, the American Academy of Family Physicians in Leawood, Kan., introduced an initiative to encourage the development of evidence-based CME. The process was piloted with 18 programs last last year, and officially launched this January. CME providers now have the option to apply for prescribed credit from the AAFP for evidence-based CME.

To help providers understand the new process, the AAFP will conduct a series of training workshops across the country. The AAFP is the first CME accrediting organization to create such a policy.

Controversial CME

Put simply, evidence-based medicine is medicine predicated on sound, scientific evidence and studies, rather than on anecdotal reports or unproven theories. It also takes into account clinical expertise.

While it sounds reasonable, EBM is controversial. Some physicians question the validity of conclusions reached by combining study results, for instance, and evidence-based doesn't necessarily mean conclusive — there is conflicting evidence about some medical practices.

Nevertheless, “EBM is here to stay in CME,” says Nancy Davis, PhD, director, division of CME, AAFP. “Residents are in EBM mode, so we need to make sure our practicing physicians are as well, and new physicians will demand it. The medical community has embraced EBM. Integrating it into CME is the next logical step.”

Where there is conflicting evidence, Davis says, “Faculty have to base their recommendations on the evidence plus their clinical experience. It is the physician learners' responsibility to decide how it fits into their practice.”

Will Others Follow?

The AAFP's EB-CME initiative was developed with input from the American Board of Family Practice and the Federation of State Medical Boards, as well as other accrediting bodies including the American Osteopathic Association, the American Medical Association, and the Accreditation Council for CME.

Asked whether the ACCME might issue a policy concerning EB-CME, Murray Kopelow, MD, executive director, says that the ACCME has put together recommendations for a new approach for CME content validation, which will be distributed for comment in January. According to Kopelow, the recommendations “are complementary to the AAFP's, but [if implemented] will not be optional.”

The AMA is “strongly supportive” of the AAFP project, but it is too early to predict how this will play out for the AMA Physician's Recognition Award system of credit, says Dennis Wentz, MD, director, division of continuing physician professional development. He explains that the AMA does not review every activity individually as the AAFP does; instead accredited sponsors designate credit. However, under current AMA PRA credit criteria, material must be scientifically valid, he adds. The American Osteopathic Association is not planning to introduce EB-CME at this time.