This 2009 report, funded by Wyeth Pharmaceuticals, aims to provide both overall findings and trends related to honoraria policies and procedures and segment-specific data. The results will be shared to allow members to benchmark their practices and procedures against those of others in similar settings.
The Alliance partnered with McKinley Marketing, Inc. to deploy an electronic survey. The electronic survey was sent in April 2009 to 1,049 members. The participants were selected at random and only one contact per member institution was invited to participate, to prevent skewing the data. The survey yielded a response rate of 27.7% (291 responses.) Typically, a response rate between 20.0% and 30.0% is considered very strong, which underscores the validity of the results and ensures that the data collected is representative of the membership.
The survey was sent to the following member audiences:
- Hospitals/Health Systems
- Medical Specialty Societies
- Medical Education & Communication Companies (MECCA)
- Medical Schools
- State Medical Societies
- Health Care Education Associations
- Federal Health Care Educators
Several trends emerge from the overall survey results. These trends provide insight into current policies surrounding CME honoraria payments. The findings are summarized in this report, both by overall findings and by specific member sections.
As a CME professional, you may know the ropes in regard to following CME accreditation and regulatory guidelines and implementing standards in your office. However, in the rapidly changing CME industry, you may find yourself in at least one of the following situations:
- A colleague from your office allows a commercial support representative to introduce a physician at your last live activity, and now you have to do damage control.
- An exhibitor and commercial supporter at your annual meeting attends a CME designated activity, then participates in Q & A, directing the conversation toward products manufactured by her company—no one present on site representing your CME office attempts to intercede.
- Your regularly scheduled course (RSC) coordinator grows frustrated with his contacts in the departments that host RSCs because they are not submitting the appropriate paperwork.
- Your employees try to edit the accreditation or credit designation statement.
- You continually get all incoming calls questioning your CME practices, because no one in the office knows how to answer them.
If you are familiar with a similar experience, then your office may benefit from an internal CME continuing professional development (CPD) strategy. Continuing professional development includes any of a variety of activities that aid your staff in learning more about CME, other regulatory requirements and the CME profession. It also involves CME employees in continuous quality improvement (CQI) activities. The activities could include tools, such as training presentations, games, surveys, and roundtable discussion, among others. You may have already recognized the wealth of feedback that employees provide about your CME program and office. Employees readily comment on your organization, though more often than not complaints comprise the majority of remarks. A CPD system channels this natural occurrence and allows you to capture candid comments and immediate reactions to situations. You may even find ways of inspiring positive or constructive feedback—even proposals for solutions—with the creative methods of training and assessment that will be discussed later.
The fringe benefits of implementing a CPD system into your office include more than fulfilling ACCME requirements. Employees will aid in increasing compliance, supporting your interpretation of the guidelines, taking more responsibility off your plate, and actively engaging in providing constructive feedback about your CME program. Often CPD activities promote team building and problem solving which may overlap into improvements in other areas of operations. Compliance may also "trickle down" to faculty and commercial supporter representatives as your employees convey their knowledge. Employees will grow professionally as they translate CME competencies into daily practice.
The step that ties everything together is assessment of your CPD program. Once you have implemented a few mechanisms, you can use simple evaluation techniques to determine whether your program is moving in the appropriate direction. If you implement changes to your CME program as a result of your CPD system, assess whether those changes have produced positive results. Last, document every single step of the way and you will have a good start for incorporating this part of CQI into the Element 2.5—Program Evaluation section of your accreditation self-study.
In a busy CME office, you may be reluctant to add another task to your already full plate, but a CPD program may be modified to fit into the most hectic schedule or provider environment. Once you determine the goals for your employees, all it takes is assessing the resources at your fingertips: human, financial, creative, equipment, and time. If you report to higher management, support from above is key to the success of a CPD program. You may want to implement a few activities and capture data about the achievement of goals or improvements in the office as an argument for establishing or maintaining a CME CPD program.
This tool has been provided for CME Professionals interested in obtaining a list of point-of-contacts regarding industry funding.
The following materials are being used by colleagues in their attempts to address the elements of disclosure and conflict of interest (COI). What may work for one group may or many not work for another. Readers should refer to the ACCME (www.accme.org) website and determine if the sample being reviewed will meet the intent of the Updated Standards of Commercial Support as well as their organization's needs.
ACKNOWLEDGEMENT: The Alliance gratefully acknowledges the University of Alabama School of Medicine's Division of Continuing Medical Education for its generous support of the tool kit and also the CME Professionals who have contributed their time, expertise and documentation in creating it.
ACCME's Standards for Commercial Support Disclosure Policy
- Sample Policy 19 – Subject: Disclosure Policy
Schools of Medicine
- Medical School Sample Policy 3 – Subject: Mechanism for Resolving Conflict of Interest
- Medical School Sample Policy 4 – Subject: Conflict of Interest Policy for Program Planners, Speakers and Authors of CME Activities
- Medical School Sample Form 10 – Subject: Faculty Disclosure and Attestation Form
- Medical School Sample Policy 13 – Subject: Letter of Agreement
- Medical School Sample Policy 14 – Subject: Planning Committee/Faculty/Author Disclosure
- Medical School Sample Form 1 – Subject: Faculty Disclosure Form
Medical Education Companies
- MECCA Sample Form 16 – Subject: Disclosure of Relevant Financial Relationships Form
- MECCA Sample Policy 17 – Subject: Identification and Resolution of Conflict of Interest Policy
- MECCA Sample Form 18 – Subject: Identification and Resolution of Conflict of interest Form
Federal Education Systems
- Federal Education System Sample Policy 5 – Subject: Conflict of Interest Policy for Federal Education System Continuing Medical Education Activities
- Federal Education System Sample Policy 6 – Federal Education System Conflict of Interest Policy
- Federal Education System Sample Form 8 – Subject: Faculty Disclosure Form
- Federal Education System Sample Form 11 – Subject: Disclosure Form Instructions
- Federal Education System Sample Form 12 – Subject: Disclosure Form
- Specialty Society Sample Policy 1
- Specialty Society Sample Form 2
- Specialty Society Sample Policy 7
- Specialty Society Sample Form 9
- Specialty Society Sample Policy 20
- Specialty Society Sample Form 21
- Specialty Society Sample Policy 22
References and Resources
- Alliance for Continuing Medical Education
- Accreditation Council for Continuing Medical Education (ACCME®)ACCME's Policies
- Tools to Support Implementation of the ACCME's Updated Standards for Commercial Support
- The Standards for Commercial Support - Standards to Ensure Independence in CME Activities
- ACCME Search Results for Standards for Commercial Support
- Revised "Identifying and Resolving Conflicts of Interest in CME" – ACCME
- Updated policies and definitions for Commercial Support and Disclosure - ACCME