Continuing Medical Education is now required. Amazingly, the content of our CME is not defined. I can receive CME on topics that I know, or topics I do not need to know.
Pharmaceutical funding for CME has come under attack and for good reason. When a company has a new drug for heart failure, they will fund heart failure talks, even if they do not specifically address the new drug. Companies with useful drugs (or even with minimally useful drugs) champion diseases. They want us thinking about their disease, because that gives their reps a chance to detail their option.
We physicians need CME and we need CME targeted to our specialties. We need input from practicing physicians and academicians to pick the topics on which we should focus.
I always thought that I had a good handle on hypertension. But last year, I heard that a colleague gave a wonderful talk on resistant hypertension. So I arranged for him to give his talk again. He taught me lessons about hypertension that have greatly improved my approach to difficult to control hypertension.
I did not know that I needed that talk. If you had given me a list of 50 potential talks, I would not have selected hypertension in the top 25.
I use the term curriculum reluctantly, but perhaps we need a CME curriculum with some hours required and some hours elective. The trick is defining in an unbiased way the "hot topics", that is the topics on which we need updating. One more example, several years ago we learned that we need to treat cellulitis differently because of community MRSA. That new information should have been placed in every CME curriculum for family docs, internists, pediatricians and ER docs.
Many critics of CME argue that CME does not positively change practice. These critics come from the outcomes police. They want to show that an educational activity changes our practices. The assumption therefore is that we physicians do such a bad job that we need remediation.
The critics also make a crucial error in their demand for outcomes data. CME should be part of a process. CME can help us in subtle ways. Good CME can help our thought processes. We might not easily find these improvements in a research study, but that fact does not invalidate the value of hearing an important talk.
I remember hearing a talk in the early 1990s that totally changed how I thought about CHF. I have used those lessons in patient care and teaching for the past 20 years. A couple of years ago I went to a talk on hyponatremia that had a positive impact on teaching and practice. This issue is not common enough to show benefit in a study, but I have helped patients because of that talk.
I believe the goal of CME should be to stimulate how we think about disease and patient care. We should strive to find the best speakers and have them speak on the most important topics. CME talks can have great value. We must find those examples and hold all CME to that higher standard.
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