Can the ACC improve its reputation and not take a financial hit? That’s the question facing the college in the wake of its recent announcement that it was revamping the model of satellite symposia at its annual meeting. Now a few more details and background information have started to emerge.
In an article in Medical Meetings, Sue Pelletier writes that the change will be “the capstone of a three-year process the College developed to clearly separate promotional and independent medical education activities.”
To replace the usual CME-accredited, industry funded symposia, the ACC “plans to use evening hours to provide some in-depth activities of its own.” In addition to these CME events, the ACC will also permit non-CME promotional programs, but these programs will be handled by the ACC’s business development division, while the CME events will be handled by the CME division.
The ACC’s chief learning officer, Joseph Green, told Medical Meetings that the overhaul began in 2008 when he joined the college:
…the way it typically worked was that a specialty society like the College asked those who had provided financial support previously if they wanted to sponsor a symposia, saving the premium time slots for exhibitors, who had first right of refusal. Then the supporters would go in search of accredited CME providers to design, certify, and put on the activity. Since the Accreditation Council for CME criteria don’t allow commercial supporters to control any aspect of the content of certified activities, “This model was out of compliance from the very start,” he says.
“Many presumed,” Green adds, “that since the society isn’t providing the credit, it’s not accountable.” He doesn’t see it that way. “If it’s held under your annual meeting’s umbrella and takes place in your meeting’s hotels, you have some level of control, and therefore some level of accountability.” Recognizing that changing long-held traditions at large organizations can’t be accomplished overnight, the College nevertheless put it high on its priority list. And change it they did: The RFPs that went out in 2007 for the 2008 annual meeting’s satellite symposia went to CME providers, not potential commercial supporters.
One immediate change was made when he came aboard:
The same staff members handled all solicitations, whether they were asking for dollars for booth space, sponsorship, satellite symposia, or commercial support for certified CME. “All of that was done by one group—and it wasn’t the education group,” says Elizabeth Yarboro, ACC’s associate vice president.
The next step of the renovation process “involved getting the annual meeting planning committee—some 75 ACC member experts—to match up the subject matter of the proposed satellite symposia with the annual meeting content, rather than have it be on random topics that might or might not integrate with the annual meeting sessions.” In the following year, “proposals were sorted into topics, then the planning committee reviewed the proposals under each topic and ranked them to determine, for example, which proposals for a diabetes symposium were best.”
The final phase of the renovation will be unveiled at the 2012 Scientific Sessions, with “in-depth, ACC-developed and –certified, independent education”:
The plan is to delve deeper into topics from the annual meeting in three-hour sessions held in the evening at a hotel, giving participants a change of scenery from the convention center where the rest of the meeting is held. These activities will be based on content pathways developed from the College’s own assessment data of competence and performance gaps, will use interactive educational techniques, and will include the assessment of outcome measures.
“There are all kinds of things we can do in a live program with 100 people over several hours that we just can’t do with 15,000 people in 40-minute sessions,” says Green. ACC will be the accredited provider for these activities, but it has not yet decided whether it will partner with other accredited or non-accredited organizations as well or keep it all in-house. These decisions will be made collaboratively with their member committees.
The college, naturally, has been concerned about the financial implications of its actions. “There was a fear at first that the change might result in decreased industry support for the annual meeting,” Green acknowledges. “That hasn’t happened yet.”
But one crucial point is still undecided, according to the article:
…while it’s still up in the air whether ACC will seek separate grants to support the new in-depth activities, the hope is that some of the companies that had been supporting the old satellite symposia model might reconsider funding the annual meeting and/or the new activities, says Green, adding, “and my assumption—which has yet to be proven—is that if we can make it more meaningful and impactful in changing competence and improving performance, industry will be more likely to support it.”
Even if eliminating the satellite symposia does have negative revenue repercussions, it still has to be done, says Green. While revenue implications were discussed throughout the process, ultimately, the ACC member committees decided that it was the right thing to do.
1) Green’s comment that until 2008 the ACC’s (and, presumably, every other major medical society’s) “model was out of compliance from the very start” is really quite extraordinary, and deserves serious consideration. But it’s not clear to me that the solution of sending out the RFPs to CME providers rather than potential commercial supporters is really anything more than a superficial change of window-dressing. After all, there can be no doubt that the CME providers are just as aware of the needs and desires of “potential commercial supporters,” and, in fact, are likely to be even more dependent on these supporters for their very existence. What is the likelihood that these providers would propose a medically sound program with a message or agenda without any sort of benefits, subtle or otherwise, to industry? Even less likely, what about a program with no commercial implications? When is the last time you saw a satellite program devoted entirely to lifestyle changes or rehabilitation programs?
2) In principle I support the college’s plan to replace the satellite sessions with in-depth CME sessions, as long as these are truly free of commercial influence. But it’s hard to understand how this can happen. I guess we’ll have to wait for more details. The ultimate proof will be not in the pudding– presumably the era of free dinners at CME satellites is now over– but in the educational content of the actual events.
3) In principle I am also not opposed to non-CME promotional events sponsored by industry, but I am disturbed that the ACC might profit from these events. In addition, as I wrote previously, the impact factor of these sort of events will be significantly diminished, and I would hope that professional leaders will fight the temptation to accept industry money for reading company slides and that they will refuse to participate in these events. It should also be remembered that all fees paid for promotional events will be required to be disclosed by industry in the near future. This is in sharp contrast to payments for CME-accredited events, for which there are no current plans to force disclosure.