The Future of CME

So I’m sitting in a large ballroom in a hotel in New Orleans listening to a plenary speaker at the Alliance for Continuing Medical Education meeting (ACME). The topic? Hot Topics in CME.

An aside: for those of you who follow me who don’t know, CME is continuing medical education, the ongoing learning that all medical professionals must complete on an annual basis to maintain their certification. It’s a huge, multimillion dollar industry and it has come under withering scrutiny in recent years for its reliance on industry (read: pharmaceutical) support and the potential for bias that introduces into the process.

Full disclosure: a significant part of my work comes from companies applying for grants to put on CME-accredited activities or from companies putting on CME activities. From what I understand, in the “old” days of CME funders did have tremendous influence; a man I talked to last night at the wine-and-cheese gathering recalled the days 15 years ago when CME funding came from the marketing department of pharmaceutical companies.

Today, however, there are thick firewalls between commercial supporters and CME programs. The funding comes out of medical education departments separated from marketing. Once the money changes hands, the commercial supporter has no influence over the program. They cannot recommend faculty, review outlines or content – nothing. Yes, they set the topic, i.e., Improving Diabetes Care in Primary Care – but that’s it.

A big part of what I do is writing needs assessments, a document that identifies gaps in the quality of care provided, gaps between “what should be” and “what is.” After three years and more than 50 needs assessments in a variety of therapeutic areas, I can definitely say that the need for CME has never been stronger.

As one speaker said during the meeting: Medicine used to be a relatively benign profession; you couldn’t do much good but you also couldn’t do much harm. That is no longer the case. Today, medicine is so complex and fast moving that there is no way anyone can practice based simply on experience and old knowledge. Today the focus is on evidence-based medicine, delivering care based on best practices as shown in quality clinical studies.

And yet there is a significant gap in the percentage of healthcare delivered based on the evidence. Most doctors simply don’t do it.

So to those who have told me over the years that CME is dying and “going away,” I have to, in the politest way possible, tell them they are full of hooey. Never before has CME been more needed. What will happen, I am sure (particularly after listening to this plenary session and attending other sessions here) is that CME will change. There may be less industry funding or, my prediction, less direct industry funding. In other words, pharma companies will pool their medical education budgets and allow the funds to be dispersed by an independent panel based on the practice gaps and educational needs identified through the needs assessment process.

There will be more point-of-care learning, more interactive and fewer didactic learning programs, and more focused learning.

But, with apologies to Mark Twain, reports of CME’s death are greatly exaggerated.

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