WHETHER WE ARE evaluating a car mechanic or a CME presenter, it is often very difficult to determine objectively whether an individual is qualified. Generally, performance qualifications are measured and evaluated against criteria such as formal education and training, experience in a specific area, test results, colleague and consumer validation, longevity, preparation, delivery, and outcome.
In CME, as in other professions, a targeted mix of these criteria should be used to determine whether an individual is qualified to address an audience of colleagues. It is absolutely inappropriate and wrong to exclude otherwise exquisitely credentialed physicians and others from CME activities simply on the basis of relationships they may have with commercial companies. Perception in such instances does not confirm the conclusion.
Learning from Industry
The practice of medicine is a lifelong journey in learning. If that were not so, CME itself would be an endangered species. Learning must and does extend beyond the boundaries of the classroom and laboratory.
Most physicians agree that discussion, dialogue, and contact with other professionals and those serving the medical profession contribute immensely to their knowledge. Relationships with commercial supporters of CME are part of the learning process. Such relationships bring new knowledge of drugs, therapeutics, and proper diagnosis, treatment, and patient care to physicians, while commercial supporters receive valuable information about product utilization patterns, positioning, marketing, adverse effects, and research requirements.
Relationships among well-credentialed, qualified medical professionals and commercial supporters can benefit CME and foster the advancement of medicine and patient care. To disqualify physicians from participation in CME activities based solely on some nebulous, unsupported perception that a relationship with a commercial supporter is of itself inappropriately influential does a disservice to the physician, to the grantor, and to CME.
Perception is subjective and intuitive and is not encumbered with the burden of proof. One of Webster's definitions of perception is “knowledge obtained through the senses.” Is that the criterion we wish to use to judge the validity of? Our courts do not place high value on perception simply because it is so subjective and variable. What one person may find to be sweet-smelling another may find offensive. And how often are we deceived by our eyes? Who, indeed, is in a position to judge the depth of personal or business relationships to the extent of concluding that a harmful outcome will result?
Stick to the Facts
CME providers should never have to disqualify physicians or other presenters on the basis of relationships unless they are known to be illegal or in some other way violate accepted social values. Providers instead are obligated to review the credentials of nominated presenters carefully against established evidenced-based criteria. Whenever the review process reveals tangible, well-documented deficiencies that threaten to weaken the learning experience and/or deliver false, misleading, or biased information, then it is the provider's responsibility to select another presenter. Just as providers would not accept perception over fact in needs assessment, so too is perception an unacceptable tool for the assessment of physician qualifications.
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.