While the CME enterprise continues to busy itself with a mixture of image-based policies, procedures, calls for comment, emotional blogs, and articles claiming “an end to CME as we know it,” a better answer is coming out of a place we wouldn't expect: the U.S. Congress.
Believe it or not, leaders in the U.S. Senate seem to understand our problem. And the best part is, they have a simple prescription to cure it.
In several telephone discussions and a live meeting this summer with top Senate and committee staff members, I was a little surprised. Not only do they understand CME and its stakeholders, they support a straightforward solution to our problems.
Catch the Bad Actors
The plan from the U.S. Senate Special Committee on Aging and the Senate Finance Committee goes like this: Catch the “bad actors” in CME and punish them. That's it? Such a simple answer left me and others with questions.
What about proposals to eliminate commercial support of CME? “Not wise,” was the answer. Congress understands that healthcare is becoming more complex, not less. Physicians and other healthcare professionals need more education, and pharmaceutical organizations have a right and a responsibility to improve overall competence and performance.
The Senate staff leaders noted that pharmaceutical companies already have spoken on the topic of funding. Maverick ideas about eliminating funding run counter to the updated Code on Interactions with Healthcare Professionals released in July by the Pharmaceutical Research and Manufacturers of America. The code is clear: “Continuing medical education (CME), also known as independent medical education (IME), helps physicians and other medical professionals to obtain information and insights that can contribute to the improvement of patient care, and therefore, financial support from companies is appropriate.”
But what about discussions of a “new paradigm” for CME? “We aren't here to break any china,” said a Senate chief investigator. “We just want to know that the Accreditation Council for CME is identifying the bad actors and taking action.” It sounds like the's new monitoring and enforcement policies could fit the bill.
What about one pharmaceutical company's policy change to not issue grants directly to medical education companies? “Confusing,” said a Senate policy leader. “There is no safe harbor in giving grants to a certain group of CME providers. Bad actors exist across the spectrum. In fact, physicians in some academic centers are not reporting millions of dollars in payments from pharma.”
Wait a minute. Is the Senate saying the CME enterprise can stop chasing its tail just by holding CME providers accountable to meet the ACCME Standards and guidelines?
Maybe we lost focus because we were too close to the issues. Or we let the headlines distract our attention from the real problem. But with a little help from Congress, we may be able to implement a simple solution that makes all our lives better.
Stephen M. Lewis, MA, CCMEP, is president of Littleton, Colo.-based Global Education Group; and president-elect of the North American Association of Medical Education and Communication Companies. Reach him at email@example.com.