Addressing threats to health care's core values, especially those stemming from concentration and abuse of power - and now larger threats to the democracy needed to advance health and welfare. Advocating for accountability, integrity, transparency, honesty and ethics in leadership and governance of health care.
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Tuesday, September 04, 2007
BLOGSCAN - To Get CME Credit, Read a "Ridiculous Text"
On the Carlat Psychiatry Blog, this post detailed the disdain for which a noted psychiatrist expressed for a ghost-written, medical education and communication company organized, pharmaceutical company sponsored CME publication which ostensibly was derived from a panel discussion in which that psychiatrist participated. His most pithy comments I will not print in this family-oriented blog ;-) Yet physicians can still get CME credit in part for reading what he called a “ridiculous text… parts of it were inaccurate, simplistic, and [contained] over-generalizations.”
Dr. Danny Carlat has done a wonderful job in bringing potential CME-sponsored conflicts of interest to the forefront.
ReplyDeleteNow that many of the problems have been noted, perhaps it is time for your readers to undertake a vigorous debate on how they would change CME it was up to them?
For whatever it's worth, here are my two cents worth: For decades now, people a lot smarter than I am have built this (CME) thing into a behemoth of complexity. Everyone has a different take on it. GSK will sponsor something that Pfizer won't, and vice versa. There is even profound disagreement in the U.S. Senate. So, I would tear the whole thing up and focus on the group of people that all of these regulations are supposed to help: Physicians.
First, merge Category 1 and Category 2 CME. Period! There's no need for both. If society cannot trust physicians to abide by the honor system, than we have bigger problems than medical education can cure. When you read a journal or attend a symposia, put the pretest, posttest and answer key in a file in your office. If you're audited you have the proof that you have been continuing your education. The medical community is a much better over-seer than the ACCME. As an MD, if you don't keep up with new science, patients—some of whom walk and talk like doctors as it is—will flush that out and make your life miserable. God forbid if you are litigated against. The amount of continuing education, or lack thereof, can come into play in court. So, it is in your personal, professional, and, perhaps, legal interest to get together with colleagues at meetings to hash things over. Enforcement becomes moot.
My second change would be that only teaching institutions can offer CME. The private medical education companies can still set-up the program, but it must pass muster from the university. Remember that all of the test grading, etc., the university would normally do has been waived, since the physician is now keeping her own records. So, the university is saving money which can be passed on to the end-user. The ACCME can monitor the
universities if they so choose, and—most importantly—standardize fees. Yes, BMS should pay a larger fee for putting on a program than should a small association or patient advocacy group. But the fee should be on a standardized, sliding scale that is universal throughout the University CME system. The end result is that the doctor gets the CME for free. That should be axiomatic—no matter who sponsors the program.
James M. La Rossa Jr.
Editorial Director & Publisher
MEDWORKS MEDIA GLOBAL, LLC
Los Angeles, CA.