Violation puts CME honor system in the spotlight

Charges brought against a high-ranking Medicare official raise the issue of greater CME monitoring for all physicians.

By Myrle Croasdale, AMNews staff. May 9, 2005.

As continuing medical education has come under increasing scrutiny in recent years, CME leaders are now keeping a watchful eye to gauge whether momentum is building for a credit monitoring system.

In a high-profile case that became public in April, the Maryland Board of Physicians charged a top Medicare policy-maker with falsifying his CME credits, prompting a small number of critics to call for changes to a system that is based on self-reporting. They want to see the current system replaced with one in which an outside organization tracks and records doctors' CME credits. They also want every state to make CME a relicensure requirement. Eleven states don't require it now.

The discussion comes shortly after critics helped change CME rules so that speakers have to disclose and resolve their conflicts of interest and three years after CME took hits for providing meals and gifts to attendees. It also comes at a time when lawmakers are pushing for medical licensing boards to step up their disciplinary efforts.

CME leaders who see no need to change the self-reporting system say it's rare for physicians to falsify the CME records they file. And physician leaders say the burden of running a CME monitoring system would outweigh the benefits.

"Do we need stronger safeguards? Do we need to ring the bell, lock the door and take roll call?" asked Robert Addleton, EdD, the Medical Assn. of Georgia's medical education director. "I don't want to put CME staff members in the place of telling doctors, 'No, you can't have a certificate because you came five minutes late.' "