THE INNER WORKINGS of major pharmaceutical companies are complex labyrinths of philosophies, regulations, strategies, plans, politics, personnel, and departments. In these labyrinths, CME is given varying levels of attention and importance. Some feel that CME is a critical component of corporate success, while others give it only casual notice. Still others are apt to ignore it completely. It should not come as a great surprise that CME requirements are less than uniformly promulgated and accepted within individual companies and, to a greater degree, from company to company.

From the Top Down

To echo the words of Mike Saxton, president, CME Best Practices, Glen Gardner, N.J., what is needed within pharmaceutical companies is a “center of excellence” focus applied to the support and delivery of needs-based, compliant CME. If the needs of physicians and patients are to be met and the system is to be improved, all who contribute to CME within the corporate structure need to be on the same page.

This is a particularly critical requirement as companies implement the new Standards of Commercial Support and OIG compliance policy. Strong signals must come from the top of the organization. When the CEO makes compliant CME a priority, perhaps even a corporate goal, the organization will follow. Staff members take notice when goals or standards against which performance will be measured are set.

But for attitudes, performance, and regulation compliance to change in the long-term, the established standard of excellence must become wedded to organizational behavior.

Therein lies the challenge for management, which must see that the CME message and regulations are delivered consistently throughout the company. The leaders in medical, legal, regulatory, marketing, sales, and professional education, for example, must all receive the same directives about current CME regulations and company policy and procedures. The best interests of CME and the company will be served further when factual examples and interpretations of the more difficult regulations are offered. Misinformed or uninformed interpretation of requirements is a real and growing danger within and among pharmaceutical companies.

Reinforce the Rules

It has been shown that most adults retain very little of what they learn over time, and that they require frequent reinforcement of concepts and ideas. These facts, coupled with the frequent changes in company personnel common at most corporations, suggest that companies would be well advised to schedule CME update sessions throughout the year, keeping all personnel up-to-date and affording the opportunity to present and explain policy modifications or changes. The use of instructors from outside the company should be considered for that purpose.

Companies that implement a collaborative approach to CME internally will have branded it as an important focal point worthy of time and effort and will have created effective partnerships among the many personnel with CME responsibility. A focus on positive outcomes will develop among those in the many groups contributing to the CME process. The resulting “center of excellence” will establish a CME brand within the company and in the professional community.

Robert F. Orsetti is assistant vice president, continuing education, University of Medicine and 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 e-mail to For more of his columns, visit