The Association of American Physicians and Surgeons (AAPS) recently passed a Resolution entitled “AMA Monopoly on Continuing Medical Education.” Jane Orient, MD, a physician from Phoenix, Arizona, and Past President of AAPS, authored the resolution. Orient was also formerly the chariwoman of the CME committee for her local hospital.
AAPS is a group promoting private medicine founded that was founded in 1943. Each year they hold an annual meeting, where resolutions such as the one noted above are discussed and voted on. Resolutions from their meeting are often used by state legislatures to help justify a position (e.g., elimination of ACCME or mandatory credit).
The proposal recognizes that “Category 1 credit is under the control of the ACCME, which is controlled by the AMA, since all “CME providers” are directly or indirectly accredited by ACCME; and “the ACCME imposes increasingly costly and onerous bureaucratic requirements that only large, well-funded organizations can meet, thereby increasing the cost of medical care.”
As a result, AAPS resolved to “promote state legislation to end the ACCME/AMA monopoly on defining CME requirements for licensure.”
We spoke with Orient, who told us that she authored the resolution because she felt that CME credit is becoming increasingly “vexing” to earn. She noted how in the past, a committee at her hospital made up of clinicians would survey the land for the most interesting and useful information for physicians and surgeons and run weekly grand rounds on that information.
Today, that committee has become a group of administrators who determine what the doctors “need” for CME at their local hospitals. As a result, the topics have shifted from breakthroughs in medicine to administrative topics, regulations, dealing with burnout, cultural competency vs. scientific advances. The focus on “need” has moved the needle to what the administrators think the doctors need, which is much different than what may be useful for the patient.
Additionally, the number of CME events or “grand rounds” has moved from once per week to once per month at her institution. She also stated what used to be “grand rounds” is much less grand with very little outside funding.
Another problem Orient pointed to was that the administration for her local hospital has been unbearable. She stated they have multiple filing cabinets full of information that for the most part is useless and has nothing to do with advancing patient care. They eventually gave up their accreditation to provide CME because they had no way of keeping up with the paperwork.
She also noted that the hospital had lost all its commercial support, so the option to bring in outside speakers became cost prohibitive. The shift has made local CME not very useful to practicing physicians. We have heard before that the administrative burden to provide accredited CME is overwhelming from many local hospitals and this should be a point of consideration for the ACCME.
Ultimately, Orient asserted that there should be more alternatives than a single accreditation system. She noted that doctors should be able to choose more freely about what they want to learn and should have less restrictions on those choices.
For now, AAPS will publicize its resolution to state legislatures and push for them to discontinue CME requirements. ACCME may want to reach out to this organization to find some common ground before states take this up.