July 2000 • Volume 6 • Number 7
Staying ahead of the game AAFP poised to revamp clinical CME accreditation system
BY CINDY McCANSE
The Academy has taken the initiative in responding to concerns of the Federation of State Medical Boards about using CME as a criterion for physician relicensure.
The concerns stem from the fact that current accreditation systems may allow credit for courses that promote or teach unproven therapies. In particular, accreditation review protocols have proven difficult to apply to activities discussing complementary and alternative practices.
Background
Early last year, the Commission on Continuing Medical Education began laying the groundwork to develop an evidence-based system for classifying CME clinical content. The COCME drafted a preliminary proposal to the AAFP Board of Directors to modify AAFP standards for evaluating and classifying clinical CME and collaborate with other national accrediting and credit-granting organizations.The COCME outlined five goals for the proposed new system:
- maximize the fairness and consistency of the CME review process,
- ensure the integrity of Prescribed credit and its acceptance for licensure and relicensure by the FSMB,
- enable the Academy to better withstand the scrutiny and concerns of other national organizations,
- assume a leadership position in this area and
- simplify the national CME landscape.
The Board approved the measure in concept in March 1999, and the COCME established the Subcommittee on Clinical Content.
Nuts and bolts
The SCC proposes that CME clinical content be classified into one of two categories:
- eligible for Prescribed or Elective credit hours -- evidence-based or customary and generally accepted medical practice, or
- eligible for Elective credit hours -- neither evidence-based nor customary and generally accepted practice, but not dangerous.
CME activities promoting any diagnostic or therapeutic intervention deemed dangerous would be ineligible for credit.
"Every intervention has evidence. It's a matter of determining what grade -- what quality -- of evidence exists." The new accreditation standards would pertain only to clinical CME topics; nonclinical topics would remain eligible for Prescribed or Elective credit under existing criteria. Both traditional and nontraditional therapies would be reviewed according to the same standards.
Identifying appropriate sources of evidence and defining a sufficient level of evidence to designate a program as Eligible for Prescribed or Elective Credit Hours have been key to the process. (See EBM story.)
As SCC member Lee Green, M.D., of Dexter, Mich., put it: "Every intervention has evidence. It's a matter of determining what grade -- what quality -- of evidence exists."
Other issues considered during this process have been the prospective roles and responsibilities of CME providers, AAFP staff and member reviewers. The concerns of AAFP constituent chapters have also been taken into account and will continue to be addressed.
Looking ahead
The COCME approved a final version of the plan last month, and it is now before the AAFP Board for action later this month. If approved, the measure will go to the Congress of Delegates this fall. If it passes muster with the Congress, an implementation plan will be developed with input from chapters, selected CME sponsors and others. A national launch date of April 2001 has been proposed.
FP Report is published by the AAFP News Department.
Copyright © 2000 by American Academy of Family Physicians.
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