Hospitalist Lenny Feldman, MD, FACP, FAAP, SFHM, of John Hopkins School of Medicine in Baltimore, is the proverbial study in contrasts. He is the longtime editor of SHM’s Consultative & Perioperative Medicine Essentials for Hospitalists, a free continuing medical education (CME) repository more commonly known as SHMConsults (www.shmconsults.com). But in February, he helped lead “Updates in Hospital Medicine 2013: Evidence-Based Reviews on the Management of Hospitalized Patients.” That program, arranged by Canadian education provider CMEatSea (www.cmeatsea.org) and held aboard a cruise ship in the eastern Caribbean, attracted some 60 hospitalists, nurse practitioners, and physician assistants interested in earning up to 14 credits.
On the one hand, Dr. Feldman is a pioneer of free virtual CME. On the other, he is an example of the big-ticket CME events that were much more commonplace five or 10 years ago.
“It’s tough,” Dr. Feldman says. “There’s no doubt that once you’ve built that virtual infrastructure, it allows many more people access to CME than if they have to come together. But with that said, particularly at a meeting like HM13, there’s so much more to it than just the CME. The networking is a huge part of that.”
This is the current state of CME, in which ever-tightening physician budgets plus a massive pullback of pharmaceutical industry support equals a landscape of fewer and fewer big-ticket events and more and more online offerings. The expense of large-scale offerings means that many physicians look for more than just the credits available when deciding which events to attend.
For many hospitalists, of course, SHM’s annual meeting remains the best opportunity of the year for CME. Accordingly, those credits are often cited as one of the biggest lures for many of the nearly 3,000 hospitalists who are expected to convene May 16-19 at the Gaylord National Resort & Convention Center in National Harbor, Md.
“You can always get CME credits locally by attending lectures at your own institution, but so often the content of these lectures is really not something that has been vetted and put forward by hospitalists,” says HM13 course director Daniel Brotman, MD, FACP, SFHM. “I think the people who attend this meeting know where the field is going, not only because of the content that’s offered, but because of who else is there. That’s different than going to an hourlong lecture by a cardiologist at your institution on atrial fibrillation.”
“There’s going to be a huge sea change there in terms of folks needing to decide where they’re going to want to spend their CME money. Are they going to choose some of these easier-to-use, online CME offerings if they think that going to meetings is becoming prohibitively expensive? Only time is going to tell.”
—Lenny Feldman, MD, FACP, FAAP, SFHM, John Hopkins School of Medicine, Baltimore
Pharma Pullback
CME budgets typically run $3,000 to $3,500 per physician, but can range from as low as $2,000 to as high as $5,000 annually, according to rough estimates from industry leaders. Opinions are mixed on whether those budgets have been significantly reduced over the past few years, but “they’re certainly not going up,” Dr. Feldman says.
What is falling year after year is the amount of money that the pharmaceutical industry is providing to support CME, says Daniel Guinee, executive vice president of educational firm ASiM of Somerville, N.J. The drug industry funded $1.2 billion of CME in 2007, according to the Accreditation Council for Continuing Medical Education (ACCME). That number dropped to $736 million in 2011, the latest year for which ACCME has statistics. Guinee says many expect the total for 2012 to be approximately $600 million, then level off.