Corporate funding of CME programs is down across the board. One simple alternative: offering CME without sponsorship of any kind.
IEG Consulting Group used to make the case to its medical-association clients that it was perfectly acceptable - legal and permissible - to accept corporate sponsorship for their continuing medical education (CME) programs. Even after the Pharmaceutical Research and Manufacturers of America (PhRMA) and the Advanced Medical Technology Association (AdvaMed) tightened up their codes of conduct several years ago, strengthening provisions dealing with exhibitor gifts and other financial transactions that might unduly influence physician behavior, “education-oriented sponsorship, as far as we’re concerned at IEG, is one of the biggest safe harbors,” said Dan Kowitz, IEG’s executive vice president. “...The way that we read it, it’s one of the safest things that you can do.”
But when it came to CME, many of IEG’s medical-association clients didn't want to do it. “We were saying, ‘It isn’t really an infomercial,” Kowitz said. “‘Give [attendees] the disclaimer. Tell them [that] this session is sponsored by - but [the sponsor] didn't influence the content.’ They understood what we were saying, but in the end they just didn't want to go for it."
Associations didn't go for it because of something that was coming straight from their CME participants. “There is a consumer feeling, a member feeling, across all the medical industries,” Kowitz said, “that if we’re going for certification, we’d really rather not have to worry about sponsor involvement: Am I truly listening to something that’s educating me and preparing me for my career, or am I listening to a pitch on hip replacement?”
79 Percent and Counting
That was the attitude that led Orly Light and her physician husband nine years ago to found MCE Conferences, a San Diego–based company offering CME programs for primary-care health-care professionals that, according to MCE’s website, are “independent of commercial support and unbiased.” “That is very important,” Light said in an interview, “because the conferences that [my husband] was going to and I was going to with him were getting out of hand with the commercial support. It was obvious that some of the speakers were promoting the products of the companies that were supporting the conference, you know?”
And then there were the show floors. “You couldn't get into the conferences unless you went by tons and tons of exhibitors that were promoting their products,” Light said. “It didn't matter whether it was a pharmaceutical company or not. If it was [at] a pediatric conference, then it was toys and children’s books and whatever else.”
PhRMA’s and AdvaMed’s recent revisions specifically tightened the screws on exhibit-hall giveaways, but couldn't really do anything about the fact that, as IEG discovered, many CME attendees simply don’t like their programs to be sponsored. With that in mind, IEG now advises clients who are CME providers to steer clear of corporate sponsorships - a philosophy that seems to reflect an industry-wide trend illuminated by the Accreditation Council for Continuing Medical Education’s (ACCME) recently published 2011 Annual Report Data: “In 2011, the majority of CME activities (79 percent) did not receive commercial support, accounting for approximately 80 percent of physician participants, and 75 percent of nonphysician participants. Twenty-one percent of CME activities did receive commercial support, bringing in approximately 20 percent of physician participants, and 25 percent of nonphysician participants.”
Rather than CME activities, IEG recommends that its medical-association clients accept corporate sponsorship for other educational programs - such as general sessions and consumer awareness campaigns. “There are no rules against sponsoring and being involved in education in the industry,” Kowitz said, adding: “There is, however, a distinction: Not all education is credential-oriented or certified.”
‘Cutting Back Excess’
But CME programs are. What do they look like without corporate sponsorship? MCE Conferences offers one possible model. A few months ago, Convene
sat down with Light at the Fairmont Washington, D.C., where MCE was presenting “Pediatric and Adult Infectious Diseases: An Evidence-Based Approach to Common Problems.” About 100 people attended the three-day program, which was funded entirely through registration (or “tuition,” as MCE calls it) - $575 for physicians and $475 for residents and other health-care professionals.
“We like to keep our conferences small,” said Light, MCE’s president, who has worked in travel and tourism “off and on” for the last 30 years. “We want to get away from the lecture-style conferences. What we want to do is have more case-based studies, more interaction between the speakers and the attendees. It makes it more interesting. It is a much better learning experience for them when they can interact with a speaker and ask questions based on what is happening and what they see at the office.”
MCE presents a half-day of content during each day of its programs - a choice that, again, was based on Light’s own experience attending medical conferences with her husband. “He would go to conferences, where it was a full day,” she said. “So you fly to a destination that took you hours to get to. You paid all this money to be there. You are excited about going to that destination, and then ended up being in a meeting room all day. Then at night you go out for supper and back to sleep and you realize, ‘What am I doing here? I could have stayed [home] and done this course online.’”
But while MCE always chooses beautiful destinations with plenty of things to see and do - usually somewhere in the Americas - its conferences aren't lavish or over-the top. “Our funding model,” Light said, “is cutting back excess.”
She recounted what she told an American Academy of Family Physicians board member who attended an MCE event and asked how the company could afford to offer “a wonderful program like this” without commercial support: “Look, you were at the conference for three days. We didn't have cocktail parties. We didn't have any big dances. We have two, three speakers, maximum. ... We cut back on all the expenses to put a conference together. We don’t have 15 people deployed to a venue from our staff. ...We travel with our own audiovisual equipment.”
MCE is also going green, recently introducing a feature on its website called myMCE that allows attendees to access and download information and materials in advance of a program. “They can print it out if they want and bring their own syllabus, because they are not getting paper at the conference,” Light said. “They get a USB drive.”
Light feels so strongly about removing the sponsorship dynamic from the picture that she and her team won’t even let attendees who are on site for one MCE program register for another. “We will give them a little bit of information about the resort and things like that,” Light said, “but more detailed stuff will have to be discussed after the conference. We are there for that conference, to service