We may have reached a tipping point: the slow, uphill progress in limiting industry involvement appears to be accelerating, and further restrictions are likely to become more widespread. These changes did not arise from one or two events. Rather, they resulted from shifting norms in the culture of medicine. It is doubtful that all industry involvement with CME will cease in the near future, and the recent decline in industry support may also reflect difficult economic times. However, we appear to be entering a new era in which earlier norms of acceptability no longer apply.
What effects will changes in CME funding have on continuing education for physicians? Those who endorse ongoing industry support argue that more stringent regulation will have negative effects on the availability, quality, and cost of CME. Although reducing reliance on industry funds will not be painless, it remains highly feasible to do so in a manner that preserves (and in some ways enhances) access and quality. Costs can be substantially reduced by avoiding high-priced venues such as the hotel conference spaces where CME events are often held. When Memorial Sloan-Kettering decided to forgo all industry support for its CME programs, it started holding its events in medical center facilities. Moreover, CME providers are de-emphasizing traditional lecture-hall–based teaching in favor of more interactive, interprofessional, and competency-based learning strategies. Such strategies include online teaching tools, point-of-care CME, and performance-improvement CME, which not only offer pedagogical value but in many cases can also be provided at relatively low cost. This trend is likely to continue as CME is increasingly linked to practice-improvement and maintenance-of-certification processes that require explicit practice-based learning.
