Macy Report — The World is Flat

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The Macy Foundation Conference Summary was a much discussed topic at the ACME meeting just held January 19-22 in Orlando, Florida.  Prior to the meeting Murray Kopelow, MD, the Executive Director of the ACCME, sent the conference summary out to all accredited CME providers and many company officials with the following note:

On January 10, 2008, the Josiah Macy Jr. Foundation released this executive summary of their November 2007 ‘Conference Convened to Address Complex Issues Concerning Continuing Education.’  It is important that we read it and understand what many people perceive is not happening in accredited CME. 

In all of our upcoming presentations and interactions, the ACCME will be talking about CME as a Bridge to Quality, and about what CME and the ACCME are already doing and what we can do about CME as a strategic asset to quality improvement in healthcare, CME as practice-based learning, and accreditation’s role in facilitating inter-professional education.
 

When asked directly at the ACME meeting, Dr. Kopelow responded that the summary was sent out only to show “what some segments of CME are saying about our industry” and “the summary was sent out to promote dialogue .    

The report can be broken down into four areas:

  • Improving education methods
  • Elimination of commercial support for CE
  • Limiting the types of organizations that offer CE
  • Creation of a NIH institute to study CE

There are many good recommendations in this report which may lead to improvements in patient care. Many of the recommendations will require significant study and funding to implement while the report calls for an up to 60% reduction in CE funding without practical solutions to replace the lost funding. 

The conference summary stated that the practice of CE is in ‘disarray’ and “bias is woven into the very fabric of CE”. These opinions are offered without references or evidence to show commercial bias by manufactures of drugs and devices. 

The report fails to address the potential for other types of bias including academic, commercial (subscription services), governmental (VA, Medicare, SBIR Grants), journals, non profits including HMO’s, Trial Lawyer and George Soros Funding.

The report also recommends the elimination of all private CE providers with the exception of Point of Care, Multi Specialty Group Practices, Hospitals and Journals (the exception list accounts for every group invited to the meeting).    The report of course called for an end of commerically supported CME in five years (Altruism rules).

It is interesting to note while we were debating this issue in Orlando, Susan Fletcher, MD, chairman of the Macy meeting was at the IOM committee on conflict of interest giving testimony on the summary (explains why the summary was released 9 months in advance of the report with no citations)

Please read the  Macy Summary and the NAAMECC and Coaltion for Healthcare Communications Repsonse to the Macy Summary

You may want to read this report from our friends at Calbin and Nobs wrote about the report, it is very entertaining. Calbin and Nob thoughts on Macy Summary

Oh we are still trying to uncover the mistery of who left the the mask and snorkle behind in Brumuda.

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