Why Isn't CME More Structured?

Let's Look at this logically: Physicians commit to a lifetime of learning. Regardless of specialty, practice setting, and/or location, one common need remains — ongoing education.

The process, however, differs from any of their previous experiences. As medical students they followed detailed schedules; as residents and fellows they tracked progress within their specialties and subspecialties and knew exactly how long it would take to complete their training. All this changes when physicians leave the formal training environment. In the snap of a finger, these physicians, who have always been in a structured learning and educational environment, are in the real world. Today it is practice management, billing, coding, business issues, and malpractice insurance — and, of course, the practice of medicine. They are no longer being told what they have to do and when. They are left to fend for themselves. If this were television, it would be “Survivor CME,” or “Last Doctor Standing.” Their lives have become a reality show!

End the Chaos

With all of these newfound challenges and requirements, how can they also be expected to stay abreast of the latest issues related to their clinical practices? Well, sometimes they just cannot. Isn't it up to us, then, as CME professionals, to be more strategic in the CME initiatives and activities that we design, develop, and implement? Our challenge would be to create a framework for physicians so their choices are not so random. Right now, physicians may decide to attend a CME activity if they get a pretty invite or if it's being held in a great restaurant. They choose activities from whatever announcements cross their desks. Do we need a more structured system? And what about the individualized needs of the learners? I don't have the answers, but I think we should be asking the questions.

CME is not simply a tactic. It frustrates me to hear learners and supporters use the acronym “CME” as a catch-all noun. For instance, a participant at a recent activity told me that the symposium was “one of the best CMEs that I ever went to.” Uh, OK, gee, thanks. I know that was meant as a compliment, but it sounded so wrong! Did he ever walk up to one of his attending physicians and say “That was one of the best patient encounters I ever had?” Probably not. He would be a lot more specific, saying, “That was one of the best presurgical patient interviews I ever had.”

What then, is the definition of strategic CME? For as long as I can remember, providers have viewed each other as competitors, at least when vying for the same grant funds. Well, it's time to rethink that view. The magic word here will have to be sharing. Instead of competing every time, consider collaborating. Specialty societies and other organizations that have constituents or other aggregations of learners would be ideal partners with other providers; together they could develop cogent needs assessments, implementing activities, and undertaking outcomes measurements.

In a collaborative environment, synergies will emerge and educational activities can be developed across delivery platforms that will meet the varied needs of the learners. There are potential economies of scale here too, including opportunities for multiple commercial supporters to come together for individual initiatives. And how about looking beyond pharma for funding? (Stay tuned for a future column on that subject.)

Finally, learners need an environment in which their specific educational needs are surveyed, met, and ultimately assessed. They need a more structured environment in which to seek out, participate in, and benefit from CME activities. So where and when do we start? Send me an e-mail with your thoughts. Until next time.

Lawrence Sherman, FACME, is president and CEO of Physicians Academy for Clinical and Management Excellence, New York. A 12-year CME veteran, he is a frequent lecturer on topics related to CME activities. Reach him at [email protected] [4].