The Accreditation Council for Continuing Medical Education (ACCME) released its 2009 annual data, which provides an in-depth view of the size and scope of the CME enterprise nationwide. The report includes statistics on CME program revenue, funding, numbers of participants and format of educational activities. The 2009 ACCME Annual Report Data marks the 12th year the ACCME has been collecting and analyzing information for accredited providers, and offers more than a decade-long perspective on the growth of the CME system (click here for previous annual reports).
The report includes information from 707 ACCME accredited providers, a decrease from 725 accredited providers in 2008.
In 2009, accredited providers produced more than 95,000 activities, a 5.8% decrease of activities from 2008, and a 15.9% decrease in activities since 2007. In fact, directly sponsored CME activities decreased over 7% between 2008 and 2009.
Despite the fact that in 2009 accredited CME activities drew more than 17 million participants, another significant finding from the report showed that the numbers of hours of instruction decreased significantly (over 10% less hours). In particular, the number of hours of directly sponsored CME activities decreased over 12% between 2008 and 2009.
The report also includes information on 1,518 local providers accredited by state and territory medical societies that are recognized as accreditors by the ACCME. State-accredited providers reported producing more than 48,000 activities, which was also a decrease from 2008, even though they drew more than 4 million participants.
Consequently, providers accredited by state and territory and medical societies saw an over 7% decrease in hours of instruction for directly sponsored CME programs between 2008 and 2009.
Total CME income also showed a significant decrease of $182 million or 7.7% less between 2008 and 2009, and from 2007 through 2009, total CME income has dropped $354 million or 14%.
Continuing this trend, the 2009 data showed a precipitous drop in commercial support from 2008 to 2009, with $183 million or 17.7% less. Since 2007, commercial support has declined $355 million or 29.3%.
As a result of this decrease, the total percent of commercial support as part of the overall CME budget dropped from 47.5% (2007) to 39.0% in 2009.
The effect of this decline in commercial support of CME proved especially difficult for professional associations and organizations, who saw a 24.7% drop in commercial support in 2009
Other organizations hit hard by the decrease in commercial support of CME were medical publishing companies, which overall saw huge drop in income: a 21% drop in commercial support from 2008 – 2009, and a 38.5% drop in commercial support from 2007 – 2009.
Although funds from the university and registrations remained unchanged at a 0.3% drop in other revenue, emptier pockets were also felt by universities who saw a significantly lower drop in total income of $18.6 million or 4.5% less from 2008-2009, and $13 million or a 5.8% drop in commercial support during the same timeframe.
Other findings showed that corporate budgets were unchanged as other income (registration and institutional funds) is down .04% (2008-2009).
In addition, the 2009 data showed that although physician users of journal CME has increased over the past year, the amount of journal CME offered has gone down 12.8%, but probably because there is less CME (e.g. 16% less courses being offered between 2008 and 2009).
Moreover, the number of hours of instruction for journal CME decreased over 30% between the same time periods. Another significant decrease seen in hours of instruction was 48.2% less hours for manuscript review.
The report did show that the number of physician participants and non-physician healthcare providers attending accredited CME programs is gradually increasing, and that more physicians are attending jointly sponsored CME programs.
The recently released data displays troubling information regarding the state of CME activities and instruction. With continued calls to end commercial support of CME, and updated rules and regulations regarding sponsorship, and disclosure, the number of activities offered is likely to continue decreasing. This trend is especially troubling considering doctors will need more CME and education in light of 30 million more people being added to our health care system.
As is evident by the significant decrease in commercial support of CME funding, and commercial funding for medical schools and associations, physicians are losing valuable opportunities to interact with their peers who are experienced and highly qualified to train doctors regarding new treatments, devices, procedures, and advances in medicine.
Others involved in CME (participants, hospitals, universities, insurers and governments) have remained financially silent with a .4% decrease in other CME funding.
While there was an increase in the number of online CME activities offered, simply replacing traditional, smaller events with online programs will not be sufficient for the hands-on experience doctors need to learn how to help patients facing complex diseases and chronic conditions.
The ACCME should address ways to help stop this trend before physicians run out of options and sources to receive meaningful CME, and collaboration between physicians and industry is taken elsewhere.
For those promoting the further reduction or elimination of commercial support one needs to consider that when you have a drug being studied, you don’t know the effects it will have on patients until its tested, studied, etc. That’s the process our system has come to accept.
But with CME, withdrawing educational support without studying the implications will leave physicians and other healthcare providers with fewer options which inevitably mean one thing: harm to patients. In other words, it should be obvious that taking away resources from doctors is detrimental for health outcomes. The scary part is, waiting 10 years to find out the impact removing commercially funded CME will have on patients a ten year gap in knowledge and practice may cost much more than the small amount spent on education.