CME Courses: compromised relationships and Payola
I am becoming increasingly concerned about over-regulation of CME programs, so much so that I would prefer to be associated with non-CME programs if they have equivalent educational goals and less interference from overzealous regulators. However, we have in our midst those who would provide CME events and then flout these regulations at the same time. We can’t play both sides of this game.
The issues are twofold, and both are pernicious. Device companies are being squeezed by organizers of certain CME meetings in a pay now and pay later ruse. Companies sign up months in advance to exhibit at a cost of $5-10K. Then they receive a call one to two weeks prior to the actual meeting and are invited to pay another $5-10K to have their device discussed at the podium. No pay … no play. I have know speakers disinvited from talking about a certain generic technology ‘because their sponsor refused to pay up’ in this double squeeze play, and ‘thus their talk would no longer be needed’. Further, new talks are susbstituted by inferior product-specific presentations merely because company ‘B’ agreed to pay up. Clearly this is flouting CME regulations, and more importantly, is an unhealthy manipulation of power and trust.
It might seem very Pollyannaish of me to hold these sentiments, but there you have it.
Conversely, I would hold the somewhat controversial view that product specific presentations are absolutely appropriate, if billed as such. The increasingly popular trend is for meetings to include technology exhibits or forums as side shows that are well funded and are represented as being exactly what they are, namely product specific promotional information sessions. Much akin to separation of church from state, there is clear separation from the main scientific sessions, and this is fine as far as I am concerned.
As a Medical Director of the SDEF meetings, I am aware that we used to do things differently in the old days ….. But now, all the CME scientific sessions need to be free of commercial bias. The meeting attendees are not always well informed enough to know when they are being snowed. Maintaining an even keel can be difficult, but common sense allows an impartial moderator to steer the content in a straightforward and candid manner. The integrity of a meeting is often based on the integrity of the session moderators, and has little to do with a boatload of CME regulations.
No amount of regulation will prevent the type of unethical end-run that some CME conference organizers are using to line their pockets at the expense of truth. So this is really a call for moderation, and for achieving a balance, for if we do not get it right, then we will reap the consequences.
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I completely agree. We can’t even run our weekly grand rounds without doing an outcomes study to prove that our educational program has merit, even though it has been approved by the ACGME. The regulators have no idea about the administrative burden this places on a department that has no commercial support. The CME regulators are trying to change the way we educate doctors, but the only result is more paperwork and meaningless objectives.
I agree ….. the pendulum has swung too far ….. but even the most restrictive of regulations is not going to prevent some meeting administrators from finding ways to screw the system.