Another Snow Day

This is a close approximation to what my house in northwest Philadelphia currently looks like.







We’ve had so much snow, I don’t think my kids even remember what school is anymore. It’s starting to turn into Lord of the Flies around here and I’m afraid I might be Piggy.

Anyhoo, all that is just a terrible segue for me to let you know that I’ve had a lot of time in front of the old MacBook Air, lately, and I’ve more or less finalized the CMEpalooza schedule. We’ve expanded the palooza to include an extra day (March 21), starting at 10 AM ET each day and ending somewhere after 3 PM. East coast bias? Yes, probably, but too bad, left-coasters. Wake up early, grab another Venti soy chai latte with extra foam and you’ll be fine (all this snow is making me unsympathetic as well as grouchy. Yikes.). You can see the March 20 schedule here and the March 21 schedule here.


Of Collaborations Loved and Lost

I thought we had something special,

You and I.

I thought we had a connection.
We communicated by email.
We talked on the phone.
We arranged to meet in person,
We clicked.
It worked.

I thought we would do great things together,

You and I.

I thought you were the one.
You said, “Follow up.”
You said, “Get back to me next week.”
You were excited to work together.
So I did.
I emailed.

No response.

“That’s OK,” I thought to myself.
I was sure you were busy.
I’ll just wait a-while longer,
I told my laptop.
And I did.
I waited.
Another week.

No response.

“Hey,” I emailed to you,
“My email’s been on the fritz.
Wanted to make sure
you got my note.
Let me know,
if you did.

No response.

Did I do something wrong?
I wondered,
Did I misspeak?
What wrong have I done to deserve
no response?
So, I picked up the phone
and I called you.


I’m glad we were able to chat,

You and I.

I’m glad we talked, again.
You said you’d been busy.
You said you’d been traveling.
You said you’ll get back to me.
I believe you.
I’ll wait

your response.



Last Week to Sign Up for CMEpalooza

The official deadline for submitting a presentation for CMEpalooza – February 1 – is fast approaching. We currently have nine presentations scheduled and if that’s what we have at the end, I’ll be 100% OK with that. Still, I’d love to see that number go up a little bit and be able to have a full morning and afternoon of educational presentations.

So, if you have any interest in doing a presentation, head on over to the CMEpalooza site right now and fill out the form. It will take you about 5 minutes. I’m telling you, doing a presentation won’t get any easier than this. You can do it from the comfort of your own home, wearing a T-shirt and slippers, with a cup of coffee in your hand (hmmm…I just described myself). I’ll control all the slides (if you have them) and ask the submitted questions (if there are any). All you have to do is look into your webcam and talk. I’ll even virtually hold your hand through a Google Hangout test run beforehand. It will be a low key, low stress environment.

After February 1, I’ll begin the process of contacting presenters and putting a schedule in place. There may still be room for any late additions, but first priority for time slot will go to those who already have submitted. If you have any questions about the process or your potential topic, please feel free to contact me.

#acehp14 Ignite Session: DIY CME

Below is my DIY CME Ignite session from last week’s Alliance conference. OK, no, it’s not the actual live session, but one I recorded beforehand using Screenr, one of the tools I talk about during the session (Yes, I used Screenr to talk about Screenr. How meta…). An Ignite session is 20 slides, 15 seconds per slide, auto-advancing. It’s not easy to put together and it’s easily the most time I’ve ever spent preparing for a 5-minute presentation.

I got two tips on putting together an Ignite session that I found to be very helpful: 1) Practice, practice, practice; and 2) Tell your story. I definitely did #1 and tried to do #2 the best I could. Unlike most presentations where I first make my slides and then talk about them during the presentation, for the Ignite session the first thing I did was write out an entire script. I edited and rewrote it until I had it down to 5 minutes and then I started breaking it into 15 second chunks. Once I had those 15 second chunks edited to make sense, then I made my slides. Since I only had 15 seconds per slide, I wanted the focus to be on what I was saying, not what was on the slides. That’s why I eschewed bullet points in favor of pictures and images, so the slides could just run in the background as reinforcement, without requiring the audience to try and speed read through them. That was my goal, anyway.

Below is the actual script I used and shows how I synched my text with the slides.


Good morning, everyone. My name is Derek Warnick and the man whose picture you see currently up on the screen is my father Don Warnick, one of the most stubborn individuals you will ever meet and a man who absolutely refused to let the words “I can’t” be used in his household.

He drove my sister and I crazy, but we understand why he did it. This is a man who grew up on a small farm in southern Delaware, where saying “I can’t” just wasn’t something you did.

When one of the tractors broke down, you didn’t say I can’t. You fixed it yourself. When the electric in the old farmhouse needed to be rewired, you didn’t say I can’t. You rewired it yourself.

When you get told at 8 years old that your aunt’s cornfield needs to be plowed and it’s not going to plow itself, you didn’t say I can’t. You hopped on the tractor and plowed it.

That do-it-yourself mentality has carried down to me, though sadly, not in the more practical areas of everyday life.


In all honesty, if I have to do much more than change a tire or light bulb, I’m at a bit of a loss. But, when we’re talking about CME and the use of technology – that’s when my DIY genes kick in.

I have been fortunate in my career in CME to have worked for a few organizations where contracting out difficult or complicated tasks, especially those related to technology, wasn’t an option.

This provided me with a great opportunity to learn how to do things on my own, without the assistance of an outside vendor or IT company.

It also helped me to realize not only just how expensive it is to put together a CME program but also that it doesn’t have to be that way, if you don’t want it to be.

And that’s what I hope you take away from this and many of the other sessions in the Technology track: given all of the advancements in technology, you have fewer and fewer reasons to say “I can’t” when it comes to creating CE or other projects for your office, no matter how small your organization.

 **** (2:00)

Here’s a quick example of what I’m talking about. I can remember spending hours putting together How-To demos using screenshots of my desktop and pasting them into Word with text descriptions. They did the job, but were both time and labor intensive.

But now, I can use one of my favorite new tools, Screenr (which you just know must be cutting-edge by the way it’s spelled), to take a screen capture video of my desktop and create and even more effective How-To demo in a fraction of the time.

Screenr is really simple to use and you can create up to a 5 minute screencast for the low-price of zero dollars.

Or, how about something a little more complex? How about a virtual conference where you can have a panel of speakers

from across the globe and streaming video that allows anyone with an internet connection to watch and participate in Q&A?

And how about if that streaming video can then be automatically archived to create an enduring internet activity?


And to top it off, how about if the technology that allows you to do this is also completely free? That is the capability provided by Google Hangouts, specifically, the Hangouts On-Air feature, which, in my opinion, has been vastly underutilized as an educational too.

Let’s take this idea one step farther and bring something like WordPress into the picture. Many of you probably know WordPress as just a blogging platform, but it can be utilized for so much more than just that.

Say you’re a small organization that can’t afford the expense of your own Learning Management System. You can use WordPress to create your own mini-LMS.

You can take that Google Hangout video that is now archived in YouTube, embed it on your WordPress site

and add one of the survey modules available to WordPress users that will allow you to create a post-test, evaluation, and customized certificate. You can create a full online CME activity with little to no coding experience.


I’ve done it. It’s not that hard. The cost of the WordPress site and survey module will set you back about a hundred bucks. No, it’s not free, but pretty darn cheap when you consider the alternatives.

When I look at all the tools that are now available to us as educators, I truly believe that we are running out of excuses for saying I can’t. If there is something you want to do, there is most likely a tool out there

that will help you do it, cheaply and effectively. In 5 minutes I have told you about 3 of them and you are going to hear about even more over the next few days through the sessions during the technology track.

I encourage you to find a tool that fills a need for you, learn more about it, and give it a try. As my dad would say, never say I can’t. You can – you just need to figure out how.

Do State Accredited CME Providers Fall Under Sunshine Act Exemption Criteria?

Things were going pretty much as expected during the Shining a Light on the Sunshine Act session at the ACEhp 2014 Annual Conference last week, when the representative from CMS (whose name I failed to catch) dropped this little doozy out of the blue:

As you may recall, one of the exemption criterion for the reporting of transfers of value is that the program meet the accreditation/certification standards of the ACCME, AOA, AMA, AAFP, or ADA DERP. An individual in the audience asked that CMS clarify that state-accredited CME providers – who are accredited by their state medical society and not directly be the ACCME – do, in fact, meet that exemption criterion. Much to the surprise of everyone in the audience, her response was “no.”

The moderator, Jacob Coverstone (who did an excellent job parsing and clarify questions), attempted to rephrase the question differently, but the response was still “no.” An individual from the audience tried a different angle and stated that since an activity from a state-accredited provider is certified for AMA PRA Category 1 credit, it is meeting the AMA certification standards and should be exempt. Again, the response from CMS was “no.”

It seemed evident to me that the individual representing CMS was confused by and/or not familiar with some of the terminology that is second nature to many of us in the CME community (ACCME accreditation vs AMA certification, etc). In her defense, she was participating remotely via audio only, which comes with it’s own challenges. The session ended with an agreement that this was an issue that would need to be discussed in more detail and possibly result in an FAQ being submitted to CMS.

This is no small matter. According to the ACCME’s current list of CME providers, there is in excess of 1200 state-accredited providers, all of whom just discovered their CME activities aren’t exempt from Sunshine Act reporting requirements. Yikes.

Please keep in mind that I am paraphrasing and writing this post based on what I remember from the session. If you weren’t there, I encourage you to listen to the archived webinar (the specific Q&A on state-accredited providers comes near the end).

(UPDATE: There is a very thorough discussion of this issue over on the CME LinkedIn Group page. Well worth your time to read.)

As a side note, I did bring up the issue of individuals with dietary restrictions now being required to report their meals, which I blogged about a few weeks ago. My question to CMS was whether the CME provider had handled the issue correctly by informing the individual who requested a kosher meal that their meal would now need to be reported, when no other individuals meal was required to be reported. The response was “yes”, and then a lot of murmuring from the crowd. So there you have it. Good times all around.

20 Things I Believe

I believe that I’m a huge fan of the recent interviews Medical Meetings has done with Dr. Murray Kopelow.

I believe that we need more of this type of advocacy on behalf of the CME community.

I believe that Pete Rose, Barry Bonds, and Roger Clemens should all be in the Baseball Hall of Fame.

I believe that Dr. Wes’s blog post on The Slow Death of the Medical Blog-o-sphere is right on the money.

I believe that the situation is even worse when it comes to CME blogs.

I believe that this makes me kind of sad.

I believe that the Bacon Batter Bread I made last week was outrageously delicious and should probably be illegal.

I believe I’m looking forward to going to the Alliance conference in Orlando next week.

I believe it’s been freaking cold in the Northeast these past two weeks.

I believe that might be the biggest reason I’m looking forward to going to the Alliance conference in Orlando next week.

I believe that the Flipped Classroom educational model might be a bit overrated.

I believe that I believe that because I believe most participants won’t do the initial work required for it to be successful.

I believe others will disagree with me and call me a Negative Nellie.

I believe they might be right.

I believe I’m looking forward to doing my Ignite Session on DIY CME next Thursday.

I believe I’m also a little nervous about it.

I believe that being an independent CME consultant can be a tough gig sometimes.

I believe that I still enjoy doing it.

I believe that the friends I have made in the CME community are incredibly supportive and I’m thankful to have them.

I believe that this “Sad Clown with the Golden Voice” cover of Lorde’s Royals is mesmerizing.

In Defense of Medical Education Companies

Yesterday, a “Brief Report” was published on the JAMA website titled Medical Communication Companies and Industry GrantsI have a few issues with the report and plan to write a more thorough response to the article with a few of my CME colleagues in the near future.

In addition, lead author Sheila M. Rothman, PhD did a brief interview with news@JAMA, which you can read here (no paywall). I would like to offer a quick response to one of the comments Dr. Rothman made on how “medical communications companies” work. Here is the question from news@JAMA and Dr. Rothman’s reply:

news@JAMA: How do medical communications companies work?

Dr Rothman: These organizations are fairly obscure and haven’t been studied. They essentially are groups that provide information they get from pharmaceutical companies and give it to consumers and physicians. They also take information from consumers and physicians and “give” it back to pharmaceutical companies.

A few points:

1) There is a difference between certified-CME and promotional education. Medical communication companies do promotional education programs. Medical education companies do certified-CME programs (the ACCME defines them as “publishing/education companies”). The companies listed in the JAMA report are ACCME-accredited medical education companies doing certified-CME programs. They do not do promotional education. They are not allowed to. This is an important distinction.

2) Just because you have never heard of something doesn’t mean it’s “obscure”. Medical education companies have been around for many years and are quite familiar to a lot of people. I never heard of Weibo until a few days ago. Half a billion registered users tells me it’s hardly obscure.

3) Medical education companies – and those that work there – do not “provide information they get from pharmaceutical companies and give it to consumers and physicians.” Developing certified-CME activities in this manner is a direct violation of the ACCME’s Standards for Commercial Support and would lead to a CME provider losing their accreditation status. There are strict regulations with regards to the communication between CME providers and pharmaceutical companies about the content of CME (to be specific: they can’t talk about it, period.) These are the same standards hospitals and academic medical centers and all other provider types are held to. I would even venture to say that since most medical education companies are aware they are highly scrutinized due to perception biases, they frequently hold themselves to an even higher standard. The content of certified-CME activities does not come from pharmaceutical companies. This may have been more of an issue 10-20 years ago, but it’s not how it works now.

4) Yes, medical education companies do “take information from consumers and physicians and ‘give’ it back to pharmaceutical companies,” but not the information implied by this article. The information given to pharmaceutical companies are outcomes reports based on evaluation and pre/posttest data from specific CME activities. These reports summarize various levels of participant outcomes for the specific activity, ranging from satisfaction with the quality of the activity to how they have used the information from the activity in their practice. Frequently, these reports include a summary of participant demographics: physicians vs non-physicians, areas of expertise, number of years in practice, etc. Personally identifiable participant information is not given to pharmaceutical companies. I cannot vouch for every single medical education company, but it is certainly not common practice. Ironically, this will unfortunately change due to the Sunshine Act. Reporting of personally identifiable information such as names, addresses, medical license number, etc, is now required for Certified-CME activities where a transfer of value, such as plated meals, is included. Don’t blame the medical education companies for this. Blame CMS.

These medical education companies have real people with real jobs working for them. It hurts me when I seem them being represented inaccurately. They deserve better.

CME Haiku

Been too busy to keep up with all the recent happening in CME? No problem, I’ve got you covered with these quick updates in (bad) haiku form. Why haiku? Why not haiku?


tempting round plate of
poached salmon and rice pilaf
license number please

for education
a meal is not essential
best track everyone


no faculty lists
on your grant applications
a fun guessing game


pew trust recommends
turn away industry funds
pay for it yourself

the other side says
why bite the hand that feeds us
we need these dollars


alliance conference
passport to innovation
rooms are going fast

ignite session stress
on stage in front of thousands
introvert needs hug


free on march 20
try cmepalooza
all the cool kids are

CMEpalooza Update

Just wanted to give everyone a quick update on where we stand with ye olde CMEpalooza, which is still scheduled for March 20 (frankly, I’m stunned that I haven’t had to move the date, yet. I’m notorious for accidentally double-booking myself, so the fact that I seem to have scheduled this on a day that I actually don’t have anything else going on is nothing short of miraculous…)

I’ll keep this short and sweet with a few key bullet points:

I really am thrilled at the response I’ve received to the CMEpalooza idea and with how many folks have signed up to present or told me they’re looking forward to checking it out. I’d love to get a few more presentations added to the agenda before the New Year, so if you have been considering it, head on over to the website and fill out the presenter form.


The New ACCME FAQ: Can We Share Faculty Lists With Commercial Supporters?

Dear Mr. The CME Guy,

Since you are clearly the most knowledgeable, insightful, and – dare I say, dashing? – CME consultant in the Northwest Philadelphia region, I am hoping you can help clear up a situation that has cropped up for me recently. One of the accredited CME provider’s that I frequently partner with just told me that they are no longer providing the names of faculty when they submit grant applications for CME programs. They claim that this is due to a recent announcement from the ACCME, but I have no idea what they’re talking about. My question to you is: what up with that?


Perplexed in Poughkeepsie


Dear Perplexed,

Thank you for your not-at-all-made-up-as -a-device-for-a-blog-post email. Indeed, the issue of whether or not it is OK to include a list of faculty in CME grant submissions has gotten a bit muddled recently. The genesis of this discussion is likely the announcement from the American Academy of Physician’s Assistant’s that they would “no longer accredit CME talks receiving grant support from BI (Boehringer Ingelheim).” In that announcement, the AAPA states:

Anytime a grant application asks for the names of faculty, as BI’s currently does, it is out of compliance and cannot be accredited for CME.

This was news to many of us in the CME community as we, like you, were not aware that supplying faculty names when required to do so in grant applications was considered out of compliance with the ACCME’s Standards for Commercial Support. I talked with a number of experienced CME professionals about this issue and while some of them had stopped supplying faculty names due to their own internal policies, none of them was aware that doing so was a matter of noncompliance. There was also not a direct reference to this specific issue on the ACCME’s website. In an effort to clarify this matter, I – and I would imagine others, though I do not know that for certain – sent an email to the ACCME asking for guidance as to the compliance of providing faculty names in grant applications.

The response I received from the ACCME directed me to this recently created FAQ, that asks the question:

Can providers be required by potential commercial supporters to share the list of expected authors or speakers with commercial supporters, during the process of applying for an educational grant?

The short answer from the ACCME is “no”, confirming the statement from the AAPA’s announcement. However, I believe there are still two fairly important questions related to this issue that remain unanswered:

  1. What is the status of CME-certified activities for which funding was previously received via grant applications that required a list of faculty? Will they be considered noncompliant?
  2. Is it OK for CME providers to voluntarily provide a list of potential faculty names in a grant proposal/application? The ACCME’s FAQ specifically only mentions cases where a faculty list is required. This is splitting hairs, I realize, but it is a question that has been asked of me by a number of people.

I have attempted to follow-up with the ACCME for a response to these two questions, but have been unsuccessful in receiving a definitive answer. As such, I am left to form my own opinions, which is more fun anyway. As to the answer for Question #1, I really have no idea. A colleague of mine stated that she believes the best approach is to simply document that you did not make changes to your faculty based on a grant request, and move on. I tend to agree with her.

As to Question #2, I refer you to the ACCME’s response to the question “How should an accredited CME provider respond to a request by a commercial supporter to review materials for an upcoming CME activity?” It’s very similar to their response to the question about faculty lists (“No CME reason…”). Note that they only specifically mention the commercial supporter requesting the content review, but never mention a provider asking the commercial supporter to do a review. Again, similar to the faculty response. How many of us, though, believe that it’s OK for a CME provider to ask a commercial supporter to do a content review? My point is, I don’t think the ACCME is splitting hairs and saying it’s OK to supply a faculty list voluntarily, you just can’t do it if required to. I think, like content reviews, they’re saying you shouldn’t do it, period. But that’s just my opinion. I could be wrong.

I apologize for such a long-winded answer, but hope this has you feeling a little less perplexed in Poughkeepsie.

Kind regards,