Institute of Medicine: CE Institute Report for Sale

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The Josiah Macy Foundation has paid the Institute of Medicine (IOM) $428,177 to form an ad hoc committee — Committee on Planning a Continuing Health Care Professional Education Institute. 

The IOM is undertaking a review of issues in continuing education of health care professionals (in particular physicians and nurses) that are identified from the literature and from data-gathering meetings with involved parties.

Based on this review, the committee is making recommendations for the

Establishment of a national inter-professional Continuing Education (CE) Institute

·         to advance the science of CE

·         Promoting the discovery and dissemination of more effective methods of educating health professionals over their professional lifetimes,

·         Developing a research enterprise that encourages increased scientific study of CE, by developing mechanisms to assess research applications,

·         Stimulating new approaches to both intra- and inter-professional CE

·         Being independent and composed of individuals from the various health professions.   

These sound like laudable goals, and would normally be treated as good news.  But  according to their agenda the real aims of the committee are

·         How can accreditation be changed to improve CE? (their answer will be to replace the current system of accrediting bodies (ACCME, ACPE, ANCC….) with a national  accrediting body.

·         To explore model CME payment methods (eliminate commercial support)

The point on being “independent and composed of individuals from various health professions” is code for only those who hold to the same believes as the signers of the Macy Report.

According to an IOM staffer the report is on a rushed schedule and the report will be made available in a book by December of 2009.  This is their first meeting and they already have a draft report outline.

The committee is made of a typical mix of educators including Kathrine DeAngelis, editor of JAMA and chief proponent to industry supported CE.

The formation of the institute was one of the key recommendations of the Macy Report released earlier this year.  So what is the connection?  According to the IOM’s own agenda: taking orders from the Josiah Macy Foundation.  The opening talk in the public session is:

Understanding the Committee’s Charge: A Discussion with the Sponsor George Thibault, Josiah Macy Jr., Foundation

This may be an accident but if you search the website there is no mention that the Macy Foundation is paying for this committee other than the talk, no disclosure which is a violation of the law.  If this was a CE program it would be considered in violation of standards of commercial support.

The Macy Foundation is also a sponsor ($70,000) of the IOM conflict of interest in Medical Research, Education and Practice committee which is expected to publish a report in March 2009.  We have reported on this several times before. This committee was stacked against industry and the Macy Foundation will have 10 days with the report prior to release to spin it whatever way they want.

Also, the agenda for the IOM Friday closed session includes “discuss collaboration with AAMC and Harvard IHP”.  This is an interesting point in that the American Association of Medical Colleges (AAMC) and Harvard Institute for Health Policy (IHP) are producing the other two Macy Sponsored Initiatives on continuing education this year.  Also, both organizations are presenting the outline of their initiatives at the meeting at the IOM on the 11th.

Most of the meeting are held in closed sessions, not open to the public.  Because this is a government agency why the closed door sessions (where is the sunshine).

The IOM is a public organization paid for by taxpayers like you and me so why would the session about Understanding the Committees Charge: A discussion with the sponsor, be in the program?  How far is the influence of the Macy Foundation on the conference that they have an agenda item about collaboration with their two other initiatives around CE.   What is motivation for the “Rush” to get this report out?

Is it a coincidence that part of the Macy Foundation Report on CE made a recommendation for an Institute and that now the Macy Foundation is paying for yet another IOM committee that supports their agenda.  Apparently the Macy Foundation developed a government venue to advance their goals.  The Macy Foundation may be using the seed money of $428,177 to get the government (IOM) to set up an institute at NIH that will cost the taxpayers multiple millions of dollars, which would in turn give grants to committee members and supporters and even the Macy Foundation itself.   This may be Macy’s attempt to get at some of the billions spent by NIH; a small investment for a potentially huge payoff.     

Following up on Macy investment of $70,000 for the Conflict of Interest Committee, which will also meet their objectives, they have been very effective in the use of their funds to promote their agenda.

According to an IOM staff person they get grants ranging from $50,000 to $10,000,000 in grants from outside groups to write reports and conduct studies which typically cost about $6,000,000.  The IOM has no public reporting structure in place to disclose where grants are coming from and amounts.   

If this program were supported by a manufacture with an opening session of Understanding the Committee Charge: A discussion with our sponsor, and no disclosure on the website, and most of the meeting being closed door, this would set off outrage by the anti industry groups and we would see congressional letters and NY Times articles discussing their influence.

The first meeting is open to the public starting at 11:15am Thursday, December 11, 2008 in room 250 of the National Academy of Sciences Building, 2100 C Street, NW, Washington, D.C.  If you are interested in registering you can at Attendee Registration.

IOM Committee on Planning a Continuing Health Care Professional Education Institute

IOM Planning Committee Biographies

IOM Project Staff Bios

IOM Agenda

IOM Attendee Registration

 

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