The survey was deployed to a panel of physicians by Medical Marketing Service, Inc. (MMS), the “industry leader in message delivery to healthcare professionals via email and direct mail.” You can find them at www.mmslists.com and on Twitter at @mmsemail.

We got 58 responses, the majority of which were from physicians who have been in practice for at least 10 years (68%). Only one responder was not currently practicing. I’m always a little leery of making broad conclusions based on a relatively small sample size, but I do think the results are interesting. It seems pretty clear to me that most physicians (well…most of these physicians, anyway) are not in favor of the increased regulations in CME that would be brought on by the Sunshine Act as currently proposed. Many of the fears and concerns that CME providers have about the Sunshine Act – and written about by groups such as the CME Coalition, ACCME, NAMEC, ACEHP, and others – are well represented by the results of this survey.

But…I’ll let you draw your own conclusions. To the data!

***

Have you ever been paid an honorarium for participating as faculty for a CME-certified activity?

• Yes (44%)
• No (55%)

A good split between those who have and those who haven’t received an honorarium. 

***

Public disclosure of all financial relationships between physicians and pharmaceutical or device manufacturers is:

• Necessary to ensure the public trust and monitor for potential bias (43%)
• Potentially confusing and misleading if not done carefully (25%)
• Unnecessary: Relationships can be managed without public scrutiny (15%)
• Potentially harmful to collaboration needed for new innovations (15%)

This shows that we don’t have an overwhelming percentage of our respondents already predisposed to being anti-disclosure. In fact, a nice percentage of them appear to be in favor of public disclosure of physician financial relationships with industry. 

***

Would you be less likely to participate as a faculty member for a CME activity funded by a grant from a company in the pharmaceutical or device manufacturing industry if you knew your honorarium and travel expenses would be reported to Health & Human Services (HHS) as a direct payment from industry and published for public viewing?

• Yes (45%)
• No (54%)

This is when things start to really get interesting. Just under half of our respondents essentially said that if the Sunshine Act is passed in its current form, they will be less willing to serve as a faculty member for a commercially supported CME activity. That cuts the pool of potential faculty members almost in half. This is one of the major fears of CME providers about the Sunshine Act: losing top-notch presenters because of concerns over increased regulations. Again, this is a small sample size, but still a troubling trend.

***

Are you less likely to participate in a CME activity if it is funded  in any part by a grant from industry?

• Yes, I am less likely to participate as a learner (8%)
• Yes, I am less likely to participate as a faculty member or planner (10%)
• Yes, I am less likely to participate in any capacity (15%)
• No (65%)

So, if a CME activity is commercially supported, a quarter of our respondents would be less likely to participate as a faculty member or planner. Add to that the possibility of their expenses being reported to HHS and the public as a direct  payment from industry and the number of those less likely to participate almost doubles. And 2/3rd’s of the respondents don’t give a hoot if it’s commercially supported or not.

***

Would you be less likely to attend a CME activity as a learner if the cost of your meal were reported to HHS as a direct payment from industry and published for public viewing?

• Yes (62%)
• No (37%)

Do you agree that all DIRECT payments in excess of $10 to physicians from industry should be publicly disclosed?

• Strongly Agree (20%)
• Agree (8%)
• Neutral (12%)
• Disagree (20%)
• Strongly Disagree (37%)

Do you agree that all INDIRECT payments to physicians from industry in excess of $10 should be publicly disclosed? For example, should an honorarium or travel expense reimbursement received by a physician from an accredited CME provider for their role in a grant supported CME activity be publicly disclosed?

• Strongly Agree (15%)
• Agree (8%)
• Neutral (13%)
• Disagree (25%)
• Strongly Disagree (36%)

Quick summary: Respondents were not too thrilled about direct payments from industry to physicians being reported (28% Strongly Agree/Agree; 57% Strongly Disagree/Disagree) and were even less excited about indirect payments (such as those from CME) being reported (23% Strongly Agree/Agree; 61% Strongly Disagree/Disagree)

***

Do you believe that classifying CME expenses (honoraria, travel, etc) as direct payments to physicians from industry that will lead to misrepresentations/misinformation regarding the relationship between commercial supporters and CME providers? 

• Strongly Agree (39%)
• Agree (27%)
• Neutral (13%)
• Disagree (12%)
• Strongly Disagree (6%)

63% of respondents believe the Sunshine Act will lead to misrepresentation/misinformation regarding the relationship between commercial supporters and CME providers. That’s bad news considering how misinformed many people already are about the relationship between the two. The last thing we need to do is muddy the waters even more.  

***

Do you believe that classification of CME expenses (honoraria, travel, etc) as direct payments to physicians from industry will positively benefit health care? 

• Strongly Agree (10%)
• Agree (6%)
• Neutral (6%)
• Disagree (27%)
• Strongly Disagree (48%)

When it comes right down to it, isn’t this what it’s all about? 75% of respondents believe health care will not benefit. Only 16% believe it will. This sums it up for me pretty well. 

***

Below are some of the comments respondents shared. There were too many to include all of them, but some were too good not to share. I’ve tried to give a fair representation of both sides of the issue, but truth be told, the overwhelming majority of comments were very negative towards the regulations included in the Sunshine Act. Some of the comments have a very definite tone of anger to them.

The last thing medical education needs is more rules.

Overall tricky issue. I do believe that industry-sponsored CME activities and the activities that surround them may have inappropriate influence on physicians.  Some are more objective than others. Disclosure is one way of addressing this problem.

I think that it is ridiculous for physicians to have such intense scrutiny and ridiculous regulations when Congress, politicians, and other professionals do not. All of the healthcare providers wish to learn and enhance their knowledge while attending dinner meetings. It is a positive way to network with other such professionals, keep abreast of new developments, and to discuss important topics which positively benefit healthcare. To limit this with increased regulations, etc. would be a tremendous mistake to the welfare of patients who in the end will suffer with physicians who have not cared to keep up with the current trends etc. Dinner, lunch meeting or other such meetings along with pens etc. do not influence physicians who care about patients and have integrity. Additionally, if these regulations occur, you will not get the same quality of speakers and physicians will be afraid to attend thereby limiting their knowledge and interaction with key opinion leaders. The Congress and politicians should first regulate themselves!

Industry’s interest in educating physicians is grounded in a profit motive, which creates an unavoidable and inherent conflict of interest with that of the physician-learner, which is (or should be) grounded in patient outcomes.

It is an insult to my integrity as a physician. It is applicable to a small number of physicians.  For thirty years I have obtained a great deal of my education from Pharmacy supported events and I practice on the basis of evidence, not pens, coffee or a dinner! I teach and present worthwhile information to other physicians made available through Pharmacy grants. It is not abused by me.

As written, and with current oversight agencies as they are, the new regs are/will be counter-productive, burdensome and ultimately cost the general public via cost of drugs and will do nothing to improve the quality of healthcare for the public.

Shrinking reimbursement and escalating malpractice premiums are driving physicians out of this profession.  Publicly disclosing CME activity honorariums and travel stipends will be detrimental.  Leave us alone!

THERE IS NO FREE LUNCH!!

No data has ever shown that disclosure benefits patients of health care.  It will benefit bureaucrats and trial lawyers, however, at an enormous expense to the health care machine which now must direct resources to the gargantuan task of tracking these payments.

A special thanks to Chris Lamond and Andy Rosenberg from the CME Coalition for guiding us through the in’s and out’s of the Sunshine Act and its potential impact on the CME community. Below is the archive from this special edition #CMEreg chat.

theCMEguy	Welcome to #CMEreg. All discussions herein are assumed to be personal opinion & not that of current, past, or future employers.
theCMEguy	Today’s #CMEreg chat is about the hot topic of the moment for CME providers: the Sunshine Act & CME
theCMEguy	We are fortunate to have Chris Lamond and Andy Rosenberg from the CME Coalition with us. They’ll be tweeting as @cmecoalition #cmereg
theCMEguy	The format for today’s #CMEreg chat will be a Q&A with @cmecoalition: I will start with a question for @cmecoalition and they will respond
theCMEguy	After @cmecoalition’s response, time is free for other related Q’s, comments, discussions from others. Please stay on topic #CMEreg
theCMEguy	After a period of time, I will bring up next Q for @cmecoalition. There will be 3 main Q’s that will be addressed (Q1, Q2, Q3) #CMEreg
BrianSMcGowan	@theCMEguy #cmereg …looking fwd to learning!
theCMEguy	We’ll start with Q1 in just a minute. For now, lets take a moment for everyone on the chat to introduce themselves. #CMEreg
theCMEguy	I’m Derek in northwest Philly, moderating #CMEreg
kenny_cox	Kenny from Springfield Mo – looking fwd to the session – #cmereg
SusanHYarbrough	@theCMEguy will there be an archive of this tweetchat? #CMEreg
beth333SP	Hello Andy & Chris! @theCMEguy: we have Chris Lamond and Andy Rosenberg from the CME Coalition. They’ll be tweeting as @cmecoalition #cmereg
theCMEguy	SusanHYarbrough: @theCMEguy will there be an archive of this tweetchat? #CMEreg>>  Yes!
greyelmy	Heather Guerrero with Gilead Sciences, Foster City, CA #CMEreg
BrianSMcGowan	Brian here working out of my car before a series of meetings…real distance learning. #cmereg
beth333SP	Beth Brillinger, Director of Accreditation for CME Outfitters. Just outside of Philadelphia #CMEreg
theCMEguy	FYI : there will be an archive of this chat posted on my blog later on cmeconfession.wordpress.com #CMEreg
ChargeAheadMktg	Glenn, Milford, CT. lurking & watching while multitasking. #cmereg
spelletier	Sue Pelletier is here, trying to catch the whole chat but forced to multitask #cmereg
theCMEguy	Are you guys at @CMEcoalition ready? #CMEreg
BrianSMcGowan	assuming tweets are personal opinion and not that of past current or future employers? #cmereg
CMECoalition	#cmecoalition here and excited to answer any and all questions #cmereg #cmereg
theCMEguy	@BrianSMcGowan You obviously missed my first tweet #cmereg
reginamotarjeme	Regina Motarjeme, out of Denver, with Medikly #cmereg
theCMEguy	.@CMECoalition: #cmecoalition here and excited to answer any and all questions #cmereg >> Great let’s get started!
theCMEguy	Q1: Can you give us a brief overview of the Sunshine Act and how it relates to CME?  #CMEreg
BrianSMcGowan	@theCMEguy i disclose that i did… #cmereg
CMECoalition	Welcome everyone.  Thanks for joining us.  New rule expands Sunshine Act to cover indirect CME payments. #cmereg #cmereg
jjuch	John J out of New Jersey #CMEreg
CMECoalition	CME will be responsible to report all payments : burdensome & large fines. Result :industry stops sponsoring CME : patient suffers. #cmereg
BrianSMcGowan	@CMECoalition – wow that makes a bunch of assumptions, no? how do you get from a to z? #cmereg
theCMEguy	@CMECoalition Have you spoken directly with people from industry about this? #CMEreg
BrianSMcGowan	@CMECoalition can we agree that industry does not ‘sponsor’ CME – they support it. word choice is critical here. #cmereg
CMECoalition	under the rules manufacuterers report if “aware” of ultimate recipient of support #cmereg
beth333SP	proposed Sunshine Act = change in perception of CME – equates independent med ed w promotional med ed #CMEreg http://t.co/odLgOkGv
spelletier	@CMECoalition report all payments to industry, right? #cmereg
CMECoalition	@beth333SP agreed.  100% #cmereg
jjuch	@cmecoalition  can you give examples of what types of payments would need to be reported? honoraria? faculty travel? meals?  #CMEreg
CMECoalition	@BrianSMcGowan yes, many, including our membership which is growing and are very concerned about this.   #cmereg
spelletier	@beth333SP That’s one of the problems all right #cmereg
beth333SP	TRUE! Vernacular is important @BrianSMcGowan: @CMECoalition Industry does not ‘sponsor’ CME, they support it word choice is critical #cmereg
CMECoalition	@BrianSMcGowan Yes. You are correct. #cmereg
theCMEguy	I think a lot of these questions will be answered in Q2. So let’s move on to that quickly and then we’ll do a few more questions #cmereg
CMECoalition	@spelletier Yes, that’s correct. Industry is responsible for reporting to feds but will require providers assistance. #burdensome #cmereg
spelletier	@cmecoalition what exemptions are there for reporting reqts? #cmereg
theCMEguy	Q2: If it is passed, how will the Sunshine Act impact CME providers? #CMEreg
CMECoalition	@jjuch  all of the above plus booths, grants to cme providers… #cmereg
beth333SP	Q2 Wondering how MD’s feel about grant supported CME honoraria being reported as direct payments by Pharma? #CMEreg #MDchat bit.ly/zQy8MK
BrianSMcGowan	what kind of booths? .@CMECoalition: @jjuch  all of the above plus booths, grants to cme providers… #cmereg”
CMECoalition	@spelletier exemptions are if covered entity is “unaware” of the ultimate beneficiaries of the payment, ed materials for patients #cmereg
CMECoalition	@spelletier also…incidental refreshments #cmereg
theCMEguy	@BrianSMcGowan @CMECoalition @jjuch I would assume this means exhibit booths, no? #cmereg
CMECoalition	@beth333SP great question: we fear a chilling effect on their participation.   #cmereg
BrianSMcGowan	t2 what guidance has there been on the accounting that will be required –> how do you divide multiple supporters/block grants? #cmereg
CMECoalition	@theCMEguy yes, exhibit booths. #cmereg
jjuch	@beth333SP Q2 …and how faculty will feel when their travel to speak at a CME-certified event appears as a “payment” #CMEreg
beth333SP	CME Outfitters has sent a survey to our physician faculty, interesting responses re Sunshine Act  #MDchat #CMEReg http://t.co/odLgOkGv
CMECoalition	@BrianSMcGowan great question.  unclear and potentially unworkable.  Needs to be a focus for comments to HHS. #cmereg
BrianSMcGowan	medical societies will be immediately paralyzed by their soft accounting practices…maybe this is a good thing? #cmereg
theCMEguy	@jjuch @beth333SP And not just a payment. My understanding is that it will link back to a specific product, too. Am I right? #CMEreg
CMECoalition	@jjuch that is our fear also.  And what about attendees?  #cmereg
BrianSMcGowan	@beth333SP do you have results to share? #cmereg
CMECoalition	@theCMEguy hard to imagine how they could do that but possible.   #cmereg
StMarysCME	What will this mean for hospital CME providers? #cmereg
BrianSMcGowan	linking grants to products may be easier for some than others…to be transparent…perhaps this is part of the confusion. #cmereg
theCMEguy	.@StMarysCME: What will this mean for hospital CME providers? #cmereg>>  Good question!
beth333SP	Why yes, I do, a few written comments 4 now, small sample size so far @BrianSMcGowan: @beth333SP do u have results to share? #cmereg
Shea_McCarthy	Did Congress intend for these restrictions on CME when the passed the Sunshine Act? #CMEreg #MDchat
CMECoalition	@StMarysCME Hospital CME providers will also be impacted.  potentially massive tracking and reporting burden…e.g., grand rounds #cmereg
jjuch	Given how different systems are for putting in grants, can you imagine all the systems for putting this info in? Ugh!!! #CMEreg
beth333SP	#CMEreg #MDChat CMEO Physician survey resp to Sunshine Act: .Slap in the face to legitimate, ethical CME providers”
BrianSMcGowan	the accounting ‘should’ be the easy part to ‘do’…but the message it sends is misguided and the effort would be overwhelming. #cmereg
beth333SP	#CMEreg #MDChat CMEO Phys resp to Sunshine Act: .Rule would potentially contribute to bias by ensuring faculty were aware of support source”
CMECoalition	@Shea_McCarthy We were told at the time that Congress intended to capture ONLY direct payments to docs, exempting CME #cmereg
spelletier	@beth333SP I’d be curious to see the responses to yr physician survey #cmereg
CMECoalition	@Shea_McCarthy We are currently talking with Members and hill staff to weigh in – CME Coalition members are on hill this week #cmereg
BrianSMcGowan	so what are the benefits of the Sunshine Act for the CME community? #cmereg
StMarysCME	I’m afraid this would be the end of many hospital CME programs.  The straw that breaks the overburdened CME coordinator’s back #cmereg
theCMEguy	@spelletier @beth333SP I believe she’s tweeting out some of the responses now… #cmereg
ChargeAheadMktg	@beth333sp on the survey, and also IYO, are the faculty responses so far concerned or “oh ok whatever”? #cmereg
jjuch	@beth333SP “contribute to bias…” interesting? not exactly what the people pushing this reporting were going for #CMEreg
beth333SP	#CMEreg CMEO Phys resp to Sunshine Act: .Wht better way 2 elim bias than cut the link, and wht better way 2 intro bias than to re-est link?”
CMECoalition	@BrianSMcGowan right on…huge burden leading to uncertain future #cmereg
spelletier	@theCMEguy yup, see them now–got behind #cmereg
theCMEguy	@StMarysCME I believe there are many who share this exact same concern. That’s why we’re doing this! #cmereg
beth333SP	yup @theCMEguy: @spelletier @beth333SP I believe she’s tweeting out some of the responses now… #cmereg
CMECoalition	@BrianSMcGowan We think there is NO upside as written/drafted.   #cmereg
BrianSMcGowan	@beth333SP that is a bizarre comment…so not knowing who the supporter is better? –> points to ignorance of many faculty #cmereg
CMECoalition	@theCMEguy This is one of the reasons CMECoalition was founded.   #cmereg
theCMEguy	Great questions and discussion everyone! I’m going to introduce the last topic to keep things moving along #cmereg
beth333SP	#CMEreg and the next comment from physicians is a long one, sorry about that. But it is also funny (sorry in advance to attorneys)
CMECoalition	@theCMEguy Many who are concerned have joined us in this fight…we need many more to keep the heat on regulators #joincmecoalition #cmereg
theCMEguy	I’ll wait til @beth333SP is done first… #CMEreg
BrianSMcGowan	@CMECoalition so either the authors see a benefit that u disagree w/ OR  the authors are blind to the facts? which is it? #cmereg
Shea_McCarthy	@CMECoalition What’s the best way to contact lawmakers regarding the #CMEreg? Does HHS accept public comments?
beth333SP	#CMEreg #MDChat Physician survey resp to Sunshine Act: .If phys and CME prov’s must report than so too must ambulance chasing attorneys”…
beth333SP	#CMEreg #MDChat Physician survey resp to Sunshine Act: .(contd) who are the saviors of humanity against the evil empire of medicine!”
theCMEguy	@BrianSMcGowan @CMECoalition So Maybe your question is, what benefit do the authors see in this for CME? #cmereg
CMECoalition	@BrianSMcGowan more likely the latter and so do congressional folks we have been meeting with. bipartisan support on hill #cmereg
theCMEguy	Q3: What can CME providers do now? #CMEreg
beth333SP	#CMEreg #MDChat CMEO Physician survey resp to Sunshine Act: .Is trying to help busy colleagues keep up w new advances really that bad?”
PSB_CME	#cmereg I think that it’s not as time consuming as people fear…just that it’s scary
theCMEguy	@Shea_McCarthy @CMECoalition An answer to this is coming shortly… #cmereg
beth333SP	#CMEreg #MDChat CMEO Physician survey resp to Sunshine Act: .Time for some well designed outcomes studies to address this disturbing issue”
jjuch	@BrianSMcGowan “…blind to the facts” and knowing what certified CME is and what we do as providers gets my vote #CMEreg
beth333SP	#CMEreg that’s all I have for now – re comments from our faculty…
CMECoalition	@theCMEguy We don’t think HHS knows enough about benefits of CME.  They beleive more transparency alwasy = better. #cmereg
CMECoalition	@jjuch certified is key and needs to be reinforced in public comments.  #cmereg
spelletier	@theCMEguy benefit is transparency, right? Tis better 2 know who gets paid by whom, thinking goes. Prob is the why is omitted? #cmereg
CMECoalition	Is everyone here planning on sending in public comments to HHS?  We hope so. For help go to http://t.co/dVvzEt14 for resources #cmereg
BrianSMcGowan	not sure who is more naive, the authors of the Sunshine act or the faculty who have their head in the sand to risk and bias. #cmereg
CMECoalition	@spelletier exactly right. they believe transparency always equals better policy.  #cmereg
theCMEguy	@CMECoalition And the due date for sending in comments is…? #cmereg
BrianSMcGowan	#TOTD #needRealExamples .@PSB_CME: #cmereg I think that it’s not as time consuming as people fear…just that it’s scary”
SusanHYarbrough	@CMECoalition submitting our response today! #cmereg
CMECoalition	@theCMEguy deadline is 2/17. Our resource center on website has all the details. #cmereg
spelletier	Assumes all financial rels are inherently bias-inducing, even with regs in place. Need to separate certified from promo #cmereg
beth333SP	YES , we are involved in multiple waves @CMECoalition: planning on sending public comments to HHS? http://t.co/w2YWmmTX #cmereg
BrianSMcGowan	@CMECoalition …but you don’t agree that more transparency is always better? #cmereg
CMECoalition	@SusanHYarbrough Great!  Thanks.   #cmereg
ChargeAheadMktg	#TOTD RT @briansmcgowan not sure who is more naive, authors of the Sunshine act or faculty who have head in the sand to risk & bias. #cmereg
theCMEguy	@CMECoalition Do public comments make a difference? #CMEreg
jjuch	Will be submitting comments tomorrow #CMEreg
CMECoalition	@BrianSMcGowan Not when there is so much burdensome redundancy with already established CME conflict protections/rules #cmereg
beth333SP	Be transparent about who selects content & faculty 2 @BrianSMcGowan: @CMECoalition …but u don’t agree that more transp is better? #cmereg
BrianSMcGowan	seems that the right step is to create polished case studies of what this Act would mean “in a day in the life…” #needstories #cmereg
CMECoalition	@theCMEguy Yes! Process is set up to avoid unintended consequences. HHS must hear from a lot of impacted parties. #cmereg
theCMEguy	@BrianSMcGowan That’s a good idea #cmereg
CMECoalition	@BrianSMcGowan Agreed: that is what we are doing in our comments and on the Hill.   #cmereg
beth333SP	BSM, Wanna spearhead that? @BrianSMcGowan: seems that the right step is to create polished case studies #needstories #cmereg
theCMEguy	What happens after the window for public comments closes? #CMEreg
beth333SP	I hear u are a good writer… BSM, Wanna spearhead that? @BrianSMcGowan: create polished case studies #needstories #cmereg
CMECoalition	@theCMEguy HHS will review all comments and post final rule. After comment period we can meet with HHS (can’t now) #cmereg
StMarysCME	When would these new regs go in to effect? #cmereg
CMECoalition	@theCMEguy We will also get Congress more engaged via letters, etc… #cmereg
CMECoalition	@StMarysCME 2013, as its drafted now. #cmereg
theCMEguy	@CMECoalition What is Congress’s role in this process? #CMEreg
jjuch	what are the chances that the final rule will be changed from current form? #CMEreg
CMECoalition	@theCMEguy Congress can also pass a law (or limit funding for) overturning the final rule..lots congress can do. #cmereg
theCMEguy	.@CMECoalition: @StMarysCME 2013, as its drafted now. #cmereg>>  Is it in effect as soon as they make a final ruling?
CMECoalition	@jjuch if we get quality arguments submitted and hill pressure to HHS we have a reasonable chance to impact the rule. #cmereg
CMECoalition	@theCMEguy No, final rule will dictate the implementation date.  Right now 2013. they could delay it but not likely at this point. #cmereg
spelletier	@cmeCoalition do you have template of main points ppl can use to draft responses? #cmereg
BrianSMcGowan	@beth333SP not sure I know enough to lead the effort but I will help…#cmereg
CMECoalition	Strength in numbers.  Please consider helping in the effort to overturn this rule and join the coalition for the prolonged fight.  #cmereg
jjuch	@CMECoalition “quality arguments and hill pressure to HHS we have a reasonable chance” so submitting comments is really important! #CMEreg
theCMEguy	Any final questions for @CMECoalition before we wrap-up #cmereg chat for today?
spelletier	@BrianSMcGowan @beth33SP likewise, would be glad to help #cmereg
CMECoalition	@spelletier Yes, our model comments are on our webiste’s Sunshine Act Resource Center.   #cmereg
theCMEguy	.@spelletier: @BrianSMcGowan @beth33SP likewise, would be glad to help #cmereg>>  I sense a G+ hangout brewing…
theCMEguy	.@CMECoalition: @spelletier Yes, our model comments are on our webiste’s Sunshine Act Resource Center.   #cmereg>>  http://t.co/y0AEa3ke
beth333SP	#CMEReg There are some great resources for info and action http://t.co/odLgOkGv & CME Coalition site http://t.co/rkuMdLg9
theCMEguy	Thank you all for participating in today’s #cmereg chat! A special thanks to @CMECoalition for joining us!
CMECoalition	Submitting public comments will be important to this effort.  Please take the time to get involved. #cmereg
beth333SP	#CMEreg Thank you CME Coalition for your involvement. Everyone needs to get involved by responding to CMS and writing our own local govt
theCMEguy	I’ll monitor the #CMEreg hashtag if anyone else has questions and pass them on to @CMECoalition
spelletier	Final question: Any way to get out ahead of the next wave before it gets to this point? #cmereg
theCMEguy	I’ll also be posting an archive of the chat at cmeconfessions.wordpress.com later today or tomorrow #cmereg
theCMEguy	@spelletier What do you mean by “next wave”? #cmereg
CMECoalition	@spelletier Yes, educating policy makers about the value of CME.  That is why we started the Coalition. Lots of catch up to do.  #cmereg

Next week – Tuesday at noon EDT to be specific – we are going to have a special #CMEreg Twitter chat with guest “tweeters” from the CME Coalition on the Sunshine Act and its impact on CME. This will be little different format than past #CMEreg (or #CMEchat) chats in that we will be using a Q&A format between the moderator and guest and then answering any questions from others in the “audience”. I will be moderating and asking predetermined questions from my @theCMEguy account. The CME Coalition will be responding from their @cmecoalition account. As already mentioned, we will use the #CMEreg hashtag for those who want to follow along.

I envision the chat to flow as follows: @theCMEguy asks question –> @cmecoalition responds –> others on chat ask questions, respond to questions, comment, etc –> @cmecoalition responds as they are able –> @theCMEguy restores order (ha!) and asks next question.

I’m not so naive as to think this is EXACTLY how it will go – this is Twitter after all – but am thinking of it as a rough structure. If possible, I ask for a little patience with your questions as it may take @cmecoalition a couple tweets to get through their response to the question at hand. On the other hand, I really have no idea what to expect. There may be a ton of questions or there might not be any at all. Either one is ok. I know people will be lurking and I’ll archive the chat so it can be read by those not available to participate live. If we get too many questions to answer during the chat (not likely, but you never know), the CME Coalition has agreed to answer them at a later time and I’ll post them somewhere for all to see.

We’ll be covering three main topics:

1) What do CME providers need to know about the Sunshine Act?
2) If it is passed, how will the Sunshine Act impact their lives?
3) What can CME providers do now?

I will try to post more specific questions next week, if possible.

OK, I think that about covers it. Once again, make sure you visit the CME Coalition’s website for resources you might find useful in learning more about the Sunshine Act and how to write a response. REMEMBER: responses are due to the HHS on February 17 (that’s next week people!)

Second of all, yes, I am again writing about the latest craze in social media. What can I say? I’m a sucker for these types of things.

Third of all…you’ve never heard of Pinterest or visited the site??? Go there right now and explore. Get sucked into the whirling vortex of imagery that is Pinterest, the social media site that drives more traffic than YouTube, Google+, LinkedIn, or (snicker) MySpace, and is on par with Twitter. Only the monolithic Facebook drives more (and a LOT more at that). I’ll wait why you click around.

<gets snack>

<twiddles thumbs>

<sighs>

<glances at watch>

<reads War and Peace>

Welcome back! For those of you who continued reading and are waiting for my description of Pinterest instead: imagine Delicious, except with images. If that still doesn’t mean anything to you: think of a page of hyperlinks, but the links are all pretty pictures. Got it?

My wife has become semi-addicted to it and I think her usage of Pinterest demonstrates the norm. As an example, she’s redesigning our guest room to be my home office. She’s goes on Pinterest or “surfs the web” (how very mid-90′s of me!), searches “Home Design” (or maybe it’s “Office Design”, I don’t really know) finds pictures she likes and “pins” them to her “board” for future reference. She can spend hours doing this.

So, of course, my first instinct was to think about how it can be used in CME (it’s a sickness, I know). I took a crack at it and came up with the following:

Diabetes PI CME: Visual list. Probably the most basic use of Pinterest, a visual list of activities. I gathered my list of from a variety of sources, but you could of course just pin your own activities. I admit that the images here aren’t that great, but I think I might like it better than a text heavy list. Need to think about that a bit.

Social Media & CME: Visual content curation. I enjoyed putting this one together and will definitely come back to it as my reference archive when writing about social media and CME. I compared it to a similar list on Delicious and definitely preferred looking at the Pinterest sight, but maybe that’s because I made that one. Also, my apologies to Brian McGowan who tweeted that his picture on the board made him look like the love child of Shrek and a creamsicle. Sometimes you have to play the hand that Pinterest deals you…

Sports Medicine Q&A: Visual list. This one I really like and see a ton of possibilities. I pinned a bunch of images from Dr. Howard J. Luks’ excellent website (if you want to see a physician who really “gets” social media, check out www.howardluksmd.com) showing a variety of orthopedic injuries, but unlabeled. Then I just asked basic questions like, “What injury do you see here?” and “Identify the problem here.” In order to find out the answer, you click on the image which is linked to an explanation on Dr. Luks site. Within 10 minutes of pinning up these images, I had 8 comments, 5 re-pins, and 8 followers. It happened so fast, I wasn’t really sure what was going on. Frankly, I’m not even sure how these people found my board (although I think it had something to do with me categorizing the board under Pinterest’s “Education” label). Obviously though, I hit on something that caught people’s eye and allowed me to accomplish two things: 1) educate; 2) drive traffic to Dr. Luks’ website (for which I’m sure he will pay me a large fee…maybe not.) Pretty cool.

Cheesy Country Songs I Listened To Growing Up In Southern Delaware: Video list. OK, admittedly this one has nothing to do with CME. I just did it for the heck of it. Actually, I did it because I was amusing my family by singing along to YouTube video clips of songs I remembered listening to on WAFL in Milford, DE when I was growing up (the look of incredulity in my wife’s eyes as I sang along word-for-word to the Oak Ridge Boy’s classic “Elvira” was priceless). But it serves as an example of yet another way to use Pinterest.

Anyone else using Pinterest in CME or healthcare? I would love to hear about it or see any examples!

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I just downloaded Socialite for Mac – not sure if I like it yet

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I have found that I like listening to TweetSpeaker on the iPhone while I drive, it reads all the tweets that I missed.

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I like tweetchat for twitter chats

Me too

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TweetDeck is my main tool. Makes tweeting, tweetchats, etc much easier. Don’t like the re-design tho

Tweetdeck is good but can be overwhelming

I only use TweetDeck for Twitter. Some like to bring in LinkedIn, FBook, etc, but I prefer not to

The auto-refresh is what puts TD over the top for me

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We stopped using Tweetdeck owing to the superior reporting capabilities of Hootsuite

agreed, i used Hootsuite too

Hootsuite app…only way to stay plugged in.

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Does anyone use #socialbro to organize subjects?

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I’m a  big fan of Evernote for curating content

ah, just discovered Evernote myself…awesome

If you use @Evernote, and add @myEN to it, all your tweets go into your Evernote acct

Evernote and Instapaper are great for saving your SoMe travels.

Evernote can also record in addition to features mentioned by @medpedsdoctor

used @Evernote Hello at the ACEHP meeting with a few people: still have @theCMEguy ‘s cool photo!

EvernoteHello loads into Evernote.  It takes a pic, remembers location, and can input directly into contacts.  free app 

E’note Hello one of many add-ons that offer specific features for the main app.

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Dropbox , Evernote are two not to live without

Agree! Big fan of DropBox…

Dropbox is a great way to connect multiple devices to eliminate the need for version control 

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Foursquare…only way to find out where @meducate is each day.

I’m curious: do some use Foursquare for safety reasons (in case they don’t show up to something, know “last location

I don’t use it so my stalkers can’t find me 

I admit that Foursquare still baffles me. I don’t “get it” and I get a lot…

If you think #foursquare is awkward wait till you try #glympse

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Happtique Pro (medical app curation).  Webicina (same).  MedCalcPro.  Skyscape.  RedBook (pediatric-specific).

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I love Zite for my tablet. It’s a great way for me to discover new content, new blogs, etc

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i saw awesome note and was wondering about it. thx for the tip, will have to check out their UI.

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Any Flipboard users out there? Had questions at #acehp12 from people wondering about RSS readers for tablet 

Flipboard=slick, but I always forget about it

I’m becoming a bigger fan of Flipboard every day – key is to customize the view, though!

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Smartr, FLUD, Toodledo, Currents, PaperDesk

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use Google Reader and delicious on my phone most days

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DuetBrowser on the tablet is pretty snazzy as well.  SidebySide: 4 sites all on one page. 

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#xobni has changed my inbox, able to keep track of each contact in the context of our conversation/project.

Used xobni when I ran windoze in emulation on my Mac but no native Mac client still?

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I use ubuntu one for remote file sharing across devices and a nifty, small encryption tool for notes called fsekrit.

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Has anyone had success with GoogleDocs or Microsoft360 to collab?  I did w limited success in content dev but failed at grant dev.

@timclynch you were my entree into Google Docs now i use it for everything 

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Have any of you used Easy Assessment?  tablet assessment tool (I think built for high school teachers?)

Easy assessment sounds interesting. 

1. Helping out at the emerging tech session Saturday morning and seeing so many new “egg” avatars popping up in the #acehp12 twitter stream.

2. Session M40 on physician empathy. Off-beat topic, nice use of Prezi and video, got the audience involved by demo’ing gloves that simulated MS and arthritis, and a free glass of wine. What more could you want?

3. Swapping stories with Brian McGowan in the hotel bar until the wee hours of the night (for those of us who consider 8:30 PM to be the wee hours…)

4. The Monday evening tweet-up which ranged from a serious discussion of the limits of social media use by physicians to busting each others chops.

5. Telling a colleague I met in person for the first time that I was an introvert and having her respond “YOU’RE an introvert?!?” Eye-opening for me.

6. And best of all, the realization of how many more people I knew and felt that I could call friends despite having never met them in person. Just an amazing, amazing experience. Whenever people ask me why they should “do” social media, this experience will be among the first things I tell them.

I watched “Moneyball” and though (as always) I found the book to be better than the movie, I once again found myself inspired. For those not familiar with the plot, my doppelgänger Brad Pitt (what?) plays Oakland A’s general manager Billy Beane who in 2002, thumbed his nose at the standard baseball conventions of the time and incorporated an “analytical, evidence-based, sabremetric approach to assembling a competitive baseball team, despite Oakland’s disadvantaged revenue situation” (thank you, Wikipedia).

To put it simply, Beane found a new approach to baseball that allowed his small market team to compete with the monolithic large market teams such as the Yankees and Red Sox. This David vs Goliath storyline was an interesting one to consider while flying to a conference where a frequent point of discussion is, how can I, a one person CME office at a small regional hospital compete in the same pool with the larger medical education companies and fully funded academic providers? What is the “new approach” that the A’s of the CME community can use to level the playing field?

To me, the answer is fairly simple. It’s social media. I’ll give you five reasons why:

1. You will be one step ahead of everyone else in learning about the latest trends in e-learning strategies, learning technologies, advances in medicine, pharmaceuticals pulled from the market, corporate mergers, you name it. A carefully cultivated Twitter list is a powerful learning tool, but it’s also the fastest way to find out about the newest developments in your areas of interest. Get on Twitter, get on Google+ (trust me on this one), and I guarantee that within a short time you will be better educated and better in tune with the quickly changing world around you.

2. It’s free! Have a limited budget for your and/or your staff’s professional development? Nothing levels the field better than free.

3. Social media is the great equalizer. Your voice can be as powerful as anyone else’s. Disagree? You’re reading this blog now, so you likely have some idea who I am. One year ago, had you ever heard of me? Had you ever heard my views on issues related to CME? The only thing that’s changed since then is my involvement with social media. It gave me a voice. One of the great challenges of being a small CME unit is simply getting people to know who you are. Social media gives you the chance to do that. It gives you an opportunity to have people say, “Oh yeah, I know you…” (And have I mentioned that it’s free?)

4. Know what the #2 search engine in the world is? It’s YouTube. People search for stuff on YouTube. A lot of people. Do you have a YouTube account? It’s also free.

5. Read this article about Children’s National Medical Center’s Google+ page. In a matter of months, they have developed a following of over 1500 people. 1500 people who are so interested in what Children’s National Medical Center has to share, they took the initiative to find them on Google+ and follow them. 1500 people that Children’s National Medical Center did not have to buy contact info for that may or may not still be accurate. 1500 people who will see whatever Children’s National Medical Center chooses to share with them next. What could YOU do with 1500 people interested in what you have to share?

(Side note: seriously, I think I might be losing brain cells. I was playing Connect 4 with my 2nd grader yesterday and he was smoking me. The first game we played, halfway through he did a Babe Ruth and called his shot. He announced he was going to beat me in ten more moves and there was no way I could win. I scoffed, continued playing, and lost in ten more moves. The second game we played, he beat me so quickly and soundly, it elicited a “Really, Dad?” from him. I’m getting old. But I digress…)

Back to the Alliance conference. Sure, there are plenty of people who have gone to far more of these than me, but there are also plenty who have gone to far less. So, I thought it might be helpful if I laid out a few tips I’ve picked up over the years as a frequent Alliance conference attendee.

1. Take the time to read the abstracts and develop a plan of attack ahead of time. Let’s face it, this is a big conference with a lot of concurrent sessions. I have tried both the “plan ahead” and the “just wing it” approach to the  conference and have found that planning ahead is much better for getting the most out of your time. I usually go through each time slot and circle every session I am interested in. I’ll then highlight the one session that interests me the most and sometimes I’ll even rank the other sessions in order of preference (wow – that’s really kind of geeky). That way, if the first session is a dud, I can quickly move on to an alternative without having to page through and read all the abstracts again.

2. Don’t be afraid to skip around to other sessions, but don’t get carried away. Look, you’re paying for the conference (or more likely, your employer is paying) so if you’re in a session that isn’t living up to expectations, by all means, move on! There’s no point in sitting through a session you’re not getting anything out of, especially when there are so many other options to consider at the same time. Pack up your things and move on to #2 on your list. Or, better yet, move on to a session that has a good buzz going on around it. Hmmm…now how could you be sitting in one session and at the same time hear buzz about another session in an entirely different area? What otherworldly invention could possibly allow you to do such an amazing thing? Surely such an incredible tool would be praised and embraced by all! (OK, it’s Twitter. I’m talking about Twitter. This is my lame attempt to try and encourage more to sign-up for a Twitter account and use it at the conference. Hey…I tried.)

The only note of caution is not to get too carried away with session hopping. My personal feeling is that if you switch out of more than one session in a 1 hour period, you’re not going to get much out of any of those sessions. You have already missed too much of it to make it worthwhile. I try to determine early on if a session is worthwhile and if it’s not, switch. If the second one isn’t any better, I either just ride it out or head into the halls to find someone to chat with.

3. Don’t feel the need to attend a session during every single time slot. It took me a few years to convince myself of this one, but it has made the conference much more enjoyable and productive for me. I always felt this need to always be in session, to always be LEARNING. Someone was paying for me to go to sessions, not to be “wasting time” chatting in the halls. This was silly thinking for two reasons: 1) I would always burnout about midway through the second day; and 2) Some of my most productive time has been spent during those hallway conversations. Once I realized that the informal learning that occurs during the side chat sessions was as valuable – if not more so – as the formal learning during sessions, it made the conference a totally different (and better) experience for me.

4. Stick with the big guns. OK, I expect this one to be a little controversial and realize that not everyone will agree with it, and that’s fine. My first few conferences, I realized I always had a lot of sessions I would really look forward to but then end up being disappointed in. It happened a lot. After a while, I started to notice a trend: frequently, these highly anticipated, ultimately disappointing sessions were given by people I had never heard of or heard speak before. The few that lived up to their billing were given by people I knew or knew were accomplished presenters. I soon started to shy away from going to the “unknown presenter” sessions and sticking with the people I knew. I also normally go to the sessions given by the ACCME and/or AMA. Given that my role in CME has always dealt along the lines of accreditation, these sessions almost always had something of value for me to take home. So by cutting down on sessions with unknowns and going mainly with known names and regulatory organizations, I felt like my time in sessions was much more productive and I had a lot less session hopping.

I feel a little bad about that one because it sounds like I’m not giving others a chance. It’s not that I never go to sessions by people I don’t know – I do and some have been quite good – I just don’t go to a lot of them. I’m curious if others have had this same experience or if you think I’m way off base here.

5. Outcomes Pecha Kucha!!! OK, this one’s only in my dreams (nightmares?), but, c’mon: if you had to choose between a round of Outcomes Pecha Kucha and another evening at Downtown Disney, which are you going to choose, huh? Oh, really? Yes, Legoland is pretty cool. What if I added in the Moore’s Levels of Outcomes Drinking Game (copyright pending), too? Still no, huh? Ah, well…

See you at the conference!

<sigh>

Oh, who am I kidding? I’m incredibly frustrated right now. I can put on my optimistic face (which is my nature) and sugarcoat it as much as I want, but none of that changes the fact that right now: this stinks.

Am I going to be OK? Of course I am.

Why?

I embrace problems…and fix them.

What’s my CME story? Here it is.
What are my qualifications? Here they are. (FYI: this is an interactive, multimedia resume that I put together which I think is kind of cool. But then…I’m a little biased.)

I will make your organization better.

And that’s it. That’s all I’ve got. I’m using all the resources I have at my disposal to find a job, but you won’t see anymore posts from me about my employment status on this blog. That’s not the intent or purpose of it, and I don’t want it to be.

We now return you to your regularly scheduled Confessions of a Medical Educator blog posts.