CME focus on professional development, ethics of gifts

Leaders in the continuing medical education field are seeking to emphasize physician development.

By Jay Greene, amednews staff. July 3, 2000.

Chicago -- Continuing medical education is moving this year to the front of the class, according to CME leaders at the AMA's annual House of Delegates meeting in Chicago.

"It is very clear to me ... CME is where the action is," said Michael Scotti Jr., MD, the AMA's vice president of medical education. "We are in a period where we are gifted with a great deal of ongoing research. Now we need to do CME in a better way if we want to make a difference in the patients we treat."

Although there are seemingly unlimited funds for CME courses on hypertension, asthma, depression and other such conditions treated with established drugs, money is scarce for professional development courses, Dr. Scotti said.

"The source of funding for CME [which mostly comes from pharmaceutical companies] is not bad, evil or wrong, but it is not directed, in many instances, to the areas of greatest need," Dr. Scotti said. There is a need for more CME courses on cultural competency, communication skills, multicultural languages and team building, he said.

Dr. Scotti also said that physicians need to be careful of the type of gifts that they accept from drug company representatives.

"Ethical issues may flavor how patients view CME practices," he said.

Toward that end, the AMA announced a "National Educational Campaign on Gifts to Physicians." The program will be funded in part with sponsorship from pharmaceutical companies. Alan Nelson, MD, former AMA president, has been named to chair the campaign.

"We are seeing a growth in the amount and level of gifts bestowed upon physicians," said Dennis Wentz, MD, the AMA's vice president of continuing physician professional development. Conditions now are similar to 1989-90, when Congress threatened punitive legislation to discourage abuses of gifts.

The campaign will seek to educate physicians on the AMA's ethical opinion on gifts. One tenet is that physicians should accept only gifts of small monetary value and only if they benefit patients.

In an effort to become more proactive, the Council on Medical Education has created a subcommittee on CME to advise the council, said James Borland, MD, a council member from Jacksonville, Fla. Subcommittees on undergraduate and graduate medical education also were created.

"We hope the subcommittee is more proactive and recommends best ways to do CME to improve physician practice," Dr. Borland said. Some CME issues include telemedicine, clinical problems associated with physicians who participate in few CME activities and Internet-based CME education, he said.

These three subcommittees will replace advisory committees on undergraduate medical education, graduate medical education and CME that were cut from the AMA's budget this year.

In other business, Paul Kitchen, executive vice president of the Medical Society of Virginia, asked the AMA and the Accreditation Council for Continuing Medical Education to relax accreditation requirements so medical societies could offer nonclinical CME courses, including ones on leadership and professional development issues.

But Murray Kopelow, MD, ACCME's executive director, said relaxing accreditation rules "calls into question the value" of the AMA Physician Recognition Award category 1 credits.

Bruce Levy, MD, representing the Federation of State Medical Boards, said state licensing boards want improvement in the quality of the content of CME courses.