CME quality has slid, docs say: poll

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A quarter of physicians in a recent survey cited a decrease in CME quality as commercial support has dropped.

The survey, fielded online by physician portal MDLinx, 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 citing a decline in quality, comments suggest that the lack of authoritative speakers 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.

Smith also noted that respondents anecdotally complained of a fall-off in the thoroughness of disease state education. 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 are no surprise to Smith. Pharmaceutical funding of CME has dropped by hundreds of millions of dollars in the past four years, requiring  doctors to shoulder more of the cost. “Whenever you've put a financial burden on physicians, they adjust their behavior,” he said.

The survey did not ask whether physicians were engaging in fewer CME activities.

Smith called the perceptions of lesser quality an unintended consequence of the increase in regulation on pharmaceutical companies' communications and their pull-out from CME. “We've squeezed everything toward mediocrity to prevent abuses.” he said.
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