That’s what the the Pri-Med Research Clinical Outcomes Study found, anyway. From the press release:

In a nationwide study to determine the influence of continuing medical education on primary care, Pri-Med Research found that significant changes in clinical practice behavior occur across the range of therapeutic areas covered at the CME programs. Among participants, 98% report using clinical information acquired at the program in their practice, and 86% continued to agree that the CME experience was a valuable use of their time, even weeks after the program was held.



The Pri-Med Research Clinical Outcomes Study surveyed primary care practitioners attending Pri-Med Updates conferences in 55 cities across the US throughout 2004. To measure changes in practice behavior resulting from the CME learning experience, participants were surveyed two weeks prior to the conference and four-to-six weeks after the event. The study addressed the diagnosis and treatment of thirteen conditions commonly presented in primary care, across a spectrum from cardiovascular and respiratory diseases to clinical depression, diabetes and gastrointestinal disorders.

Among practitioners surveyed, a significant increase could be seen for both knowledge and adherence to clinical standards (a 15% and 13% increase, respectively) based on information presented at the CME program. Furthermore, confidence in treating patients increased an average of 16%.




“Self reported changes in knowledge, application of best practice standards and confidence in treatment have an immediate impact on patient care and clinical outcomes,” Alan Lotvin, MD, president of Pri-Med, said. “It is clear evidence that effective CME translates directly into better healthcare.”

Impact Varies Widely With Diagnosis




“Not surprisingly, the effect of CME in improving clinical practice behavior is more pronounced in relation to conditions primary care physicians encounter less frequently,” Marissa Seligman, Chief Clinical and Regulatory Affairs Officer, VP of Pri-Med Institute, said. “The study correlated reported changes in knowledge and application of clinical guidelines as well as confidence in treatment with the average number of patients seen each week across thirteen disease categories. The most significant changes in practice behavior were seen in less commonly treated conditions such as anemia, genitourinary infections, sleep disorders, neuropathic disorders, and sexual dysfunctions. For cardiovascular, gastrointestinal conditions and allergies, the greatest impact of CME can be seen in its ability to reinforce and expand knowledge among practitioners who regularly treat these conditions.”

This post courtesy of Anne Taylor-Vaisey: Here is an interesting article from the November 5 issue of BMJ:

 

Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources, Trisha Greenhalgh, Richard Peacock

BMJ  2005;331:1064-1065 (published 17 October 2005)

Objective To describe where papers come from in a systematic review of complex evidence.

Method Audit of how the 495 primary sources for the review were originally identified.

Results Only 30% of sources were obtained from the protocol defined at the outset of the study (that is, from the database and hand searches). Fifty one per cent were identified by “snowballing” (such as pursuing references of references), and 24% by personal knowledge or personal contacts.

Conclusion Systematic reviews of complex evidence cannot rely solely on protocol-driven search strategies.

 

Free full text

I received an e-mail announcing that several medical education/medical and drug information/medical strategy positions are open at Bristol Myers Squibb:

Manager, Associate Director and Director level available.

All therapeutic areas are needed.

Positions are located in Princeton, NJ.

Relocation assistance provided

If you’re interested, feel free to e-mail your resume to Bob Weinstein of The Carolan Group.

According to a national poll by the American College of Physician Executives, almost 40 percent of the surveyed docs already are participating in some sort of pay-for-performance program, and almost 60 percent of those who aren’t yet are thinking about it. That doesn’t mean everyone’s happy with the idea, though. From the press release:

As one poll respondent put it, pay-for-performance programs “are an inevitable rising tsunami that will overtake us.”



Bonus pay for taking better care of patients certainly is controversial.




“It is embarrassing to have to be paid to improve quality … our industry has been lax,” one poll respondent wrote.




But a critic of bonus pay put it bluntly:

Pay-for-performance programs “are the most recent scam to be perpetrated on physicians. Agree to them at your own peril. All physicians will regret their participation in any such program.”

While 75 percent agreed that these programs reward physicians for meeting their performance goals, and 60 percent believe they encourage docs to improve patient care, only 38 percent believe P4P programs will help reduce the likelihood of medical errors. And it seems like I’m far from alone in this fear:

One of the most alarming concerns about pay-for-performance is the fear that doctors will avoid or refuse to treat patients in order to improve their overall scores and get the bonus money.



“There will be a dumping of non-compliant or difficult patients in order to have physicians performance appear good,” one respondent predicted.

To obtain complete survey results and copies of the related articles, contact Bill Steiger at ACPE at bsteiger@acpe.org or 800-562-8088.