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We believe a strong, effective, and fair ACCME is critical to the continuing growth of the CME enterprise. We believe the new "Policy Updates", released last month, are for the most part, a constructive enhancement of ACCME's governance of CME.  However, there are portions of the new policies that appear to conflict with ACCME’s mission of providing a consistent “voluntary self-regulated system for accrediting [all] CME providers.”  One example, the ACCME seems to be creating two classes of CME providers; one class where the potential for financial conflicts of interest requires extraordinary action and another class where ACCME appears to believe that the same potential does not exist.

It’s appropriate to support ACCME's position that drug and device companies should not be accredited providers.  Their future is too closely linked to their product successes to expect them to be totally objective.  What is inconsistent with a fair and balanced body of regulations is the idea that commercial support from drug and device companies is more likely to bias the CME activities produced by one group of accredited providers than another.

If ACCME’s assumption is that commercial support has the potential to introduce bias, then to guard against it, all providers need to establish safeguards to insure the independence, balance, objectivity and scientific rigor of the activities they certify.  A provider's ownership, tax status or involvement in the direct provision of care to patients does not offer any protection against bias.

There has been conscientious, significant, and widespread progress among for-profit accredited providers and MECCs to build firewalls by separating staff, management, locations, incentives, procedures, etc. to provide environments in which independent, non-biased CME activities can be created.  This effort has not been duplicated by those accredited providers involved in direct patient care, some of whom have for-profit commercial patient enterprises.

If ACCME firmly believes that commercial support has the potential to bias CME activities, then every provider should be held accountable to the same standards and safeguards to protect the integrity of CME. To do less would impugn the objectivity and integrity of ACCME’s regulations.