About one out of four physicians in a recent survey cited a decrease in the quality of CME programs as commercial support has dissipated.
Pharmaceutical industry funding of CME has dropped by hundreds of millions of dollars in the past four years. With fewer grant dollars available, the number of providers has fallen, and there are fewer hours of instruction being produced.
The survey, fielded online by physician portal MDLinx over two days in December, sought to determine the impact on quality, such as speakers and course content. Out of 515 doctors polled, most—64.1% (330)—said there was no change, while 9.3% (48) said quality has increased. But 137 (26.6%) reported that they sensed a decline.
“That [26.6%] should shock everybody,” said Stephen Smith, chief strategist, MDLinx. “I wouldn't expect so many to say quality has decreased, because if pharma is not sponsoring [CME], who is? Major medical centers.”
Among those who cited a decline in quality, comments suggest that the lack of authoritative speakers—a hallmark of pharma-backed CME—is what they miss most. One theory, according to Smith: academic medical centers are sending clinicians to the podium who are not as connected to the practicing community doctors as was previously the case and thus are not as sharp and insightful.
In addition, Smith noted, these respondents anecdotally complained of a fall-off in the thoroughness of disease state education. Among other findings, another 330 (64.1%) said they have had to pay more for the cost of CME for themselves or staff, while 52.2% (268) have had to spend more time and effort locating appropriate CME.
The access issues come as no surprise to Smith. “Whenever you've put a financial burden on physicians, they adjust their behavior,” he said. “I assumed that the doctors would say it's harder to find CME now, and we have to pay for it and have to spend more time and effort doing it.”
The survey did not ask whether physicians were engaging in fewer CME activities. Most have a minimum requirement to maintain licensure and hospital privileges, but many used to take part in programs without claiming credit. "The majority of doctors spend time in CME programs just to learn,” he said, so the regulatory bodies can't track changes in their attendance.
Smith called the perceptions of lesser quality an unintended consequence of the increase in regulation on pharmaceutical companies' communications and their resulting pull-out from CME. “We've squeezed everything toward mediocrity to prevent abuses.”