You know that CME is in a bit of trouble when its longest-serving provider is hanging up its accreditation credentials and stepping out of the game.
“The CME enterprise has gotten bogged down in disputes, misconceptions and misguided regulatory initiatives,” charges Jon Bigelow, president and CEO of KnowledgePoint360, which owns the soon-to-be-disbanded mainstay CME provider, Postgraduate Professional Services (PPS). “Many of pharma's critics have gone to illogical extremes that will hurt the healthcare system and patient care. In this environment, neither supporters nor providers can plan effective activities to meet the long-term needs of busy practitioners.”
Other firms are bound to follow PPS's example. The ethical fires raging around industry-funded CME, and a clutch of other factors such as the economic climate, have conspired to squeeze the sector hard. The truth is that, for many accredited providers, financial support is drying up.
“Two years ago, maybe one out of every five grants would get funded,” notes Marty Cearnal, EVP, chief strategy officer of Jobson Medical Information. “Today that number is one out of every 20-30.”
According to recent figures from the Accreditation Council for CME, in 2007 (admittedly, not that recent) industry support of publishing and education companies for accredited programs declined by 4.2%. In fact a 2008 AAMC/SACME Harrison survey highlighted, somewhat glaringly, that 121 out of 145 courses that the average school conducted in 2006-07 would not have been offered without support from pharma.
For ACCME chief Murray Kopelow, this is all part of the process. “This is the time for evolution, not adaptation,” he says, somewhat unmercifully. “Some people will move on to other professional pursuits, some organizations will stop being accredited providers, new people will be drawn to the CME enterprise and new organizational types will emerge as providers. It is mission critical that CME be about improving quality and safety, be content valid and developed in a manner that is independent of the influence of commercial interests.”
And so, an increasing number of providers are rebelling against accreditation. But, these days, it seems non-accredited courses are hardly your father's promotional programs—often served with generous helpings of sun and sand. “Pharma companies are increasing the quality and substance of their non-CME programs,” says Dara Warn, vice president at Pri-Med. “Physicians are going to these programs because they're quality and high information.”
Linda Klein, president and CEO of Klein & Co., agrees. “These are well-balanced programs presenting where the product fits into the scheme of clinical practice, along with the rationale for that, and obviously staying within the label,” she says. “Healthcare professionals are not going to attend a commercial.”
If this is in fact the case, isn't the ethical backlash against commercially funded CME, and the continuous scrutiny and allegation surrounding pharma's subsequent influence and bias, just a little over the top?
“I attended a convention over the weekend,” observes Surge Worldwide president Carleen Kelly, “and I couldn't believe that reps had nothing they could share with physicians except their sales aids.”
For more trends in CME, check out the MM&M Med Ed Guide 2009, published with this issue.