She talked a lot about various competency frameworks, and the similarities (many) and differences (few) between those developed by U.S. and Canadian organizations. She also provided a fairly daunting list of challenges for interprofessional education, from stereotyping to time, geography (we both have big countries), to resources, power/hierarchy issues, political will, unions, professional regulators, and policies that don’t support team-based approaches.

She says she wants to “put the ‘I’ back in teamwork,” meaning that people need to take personal responsibility for examining what stops us from collaborating effectively as practitioners. What barriers do you face? She gave us several areas to think about:

* Social capital: Basically, this is about trust and respect. How do you build these among colleagues and team members? How do you lose them? Are there “teachable moments” in everyday interactions you can take advantage of to build trust and respect?

* Rhetoric: The words we choose can make all the difference in an interaction. She suggested practicing word choice in e-mail, since it has a built-in time delay you don’t get in conversation. What words do you use? Does a disregard for grammar and spelling indicate a disregard for the recipient? Think about it.

* Perspective taking: Remember, her colleague told her, it’s not all about you (what??). How do you figure out where another person is coming from? How can you teach others to discover others’ perspectives? This one is particularly sticky, I think.

* Negotiate priorities: How do you work with others to determine what’s important and what isn’t?

* Resolving conflicts: How do you create a safe place to have conversations around areas of conflict?

* Building relationships: How do we build relationships, and how do we teach people to build constructive relationships with colleagues?

He set the stage by citing just how bad it is in the U.S. (32 percent of patients say they’ve experienced medical and/or lab errors, more than a slew of other countries he listed, and our readmission rates are pretty dismal). And costs are seriously out of control: U.S. salaries have increased 38 percent over the past 10 years, while healthcare costs have soared 131 percent. If milk had that inflation rate, it would cost $48 per gallon. Yikes, anyone! While the cost of care in the U.S. is double that of other Western nations, they’re also experiencing ridiculous (my word, not his) healthcare inflationary rates.

But while things like healthcare reform, CMS’ PQRS, Maintenance and Certification and likely soon, Maintenance of Licensure, and ARRA and HITECH, and other acronyms I think I missed as we whizzed through the slides, are aligning, there are still misalignments, he said.

Quoting Don Berwick, he said, “You can’t fatten a pig by weighing it repeatedly,” meaning that while it’s great we’ve put work into measurement and reporting, it’s now time to focus on improvement.

Among his recommendations:

* Get to know the national performance improvement initiatives (NQF, NPP, etc.) Join them.

* Adopt NQF and NPP recommendations as a framework for what you do.

* Facilitate national and local discussions between measurement improvement groups, CPD groups, and HIT groups. As he said, the other two groups already are starting to come together, and “You need to get into the dance.”

Gabrielle Kane, president of the Society for Academic CME, then took to the stage to talk about the “family reunion” feeling of working with ACEHP, with the support of a healthy grant from Pfizer specifically aimed at improving research in CME. She outlined the SACME research agenda, which is based on two main projects at this point: A literature review to identify gaps and guide new research; and a taxonomy project. She invited Alliance members to participate in both.

I’ll get the whining out of the way first:

-Yes, I already have stuffed-brain syndrome from having way too much thrown at me in too little time with no connection between session topics and no time for reflection built in.

-We hit the “I know you can’t read this slide, but…” wall before the first general session was over.

-We hit the “I know this classroom setup makes it almost impossible to break into small groups, but we’ll have to do our best…” shortly thereafter.

-Healthy food is good, but replacing the chips with bean salad and the cookie with an apple in the bag lunch seems a bit over the top. Must we resort to Starbucks for all our dietary sins?

-Speaking of over the top, is it just me, or are there way too many sessions to choose from? I know, tough problem to have, but I’m finding myself torn between six or seven I want to go to in every single time slot. It’s making me crazy to be missing so much good content (and hearing people tweet about some of those sessions to the #acehp12 hashtag just makes it worse).

Awesome aspects, meeting-wise:

-Free WiFi! Thanks to Bernie Halbur, PhD, FACME, ACEHP’s Professional Development & Meeting Management Director, for making it happen, along with everything else we’re enjoying logistically. I gave her a standing ovation when she was recognized yesterday at the general session, and I wasn’t the only one.

-Love having the brief outdoor breezeway walk to the exhibition area, and the tables set up for eating/hanging out/computing along the way. At least we’re assured of the opportunity to catch five minutes or so of the gorgeous Florida weather as we go back and forth, instead of never even knowing if the sun is shining or not, as so often happens at marathon meetings.

-Beautiful hotel (the JW Marriott), beautiful rooms, nice jogging path, great fitness center. I don’t know much about golf, but the course looks good to me.

-Being able to hold the new CCMEP celebration out on the patio last night was a wonderful touch. Again, being able to get outside in January means a lot, especially to those of us who hail from the frozen North!

(Cross-posted on face2face.)

According to a press release, CME Peer Review, produced the video to “help advance awareness of COI with a goal of enhancing the quality of continuing education. ‘Standardized, effective management of COI allows planners and faculty to focus on what is important – enhancing patient care,’ says Jane Ruppenkamp, President, CME Peer Review.”

Once we learned the conference’s Twitter hashtag (#acehp12) and how to pronounce ACEHP ( “a-sep,” according to one poster. “Think antiseptic”), and got an update on the weather forecast—“fluorescent and 70 degrees”—we dove into lessons learned/favorite experiences from past Alliance meetings. These included:

• Don’t feel you have to stay in a session that you’re not getting anything out of.

• Don’t worry about missing sessions in favor of hallway conversations. These conversations, and the relationships that can come out of them, are some people’s best conference experiences.

• It can be empowering to look around and realize how many others in the room are in the same boat as you.

• Keep an open mind. “Some of my best ideas came from conversations with people who disagree with me,” said one person. I can’t agree more.

• It’s great to be able to meet people we previously had only known virtually.

• Know that those who preach adult learning principles don’t always practice what they preach.

• Make dinner reservations ahead of time.

• Don’t let the faculty off the hook if they start glazing over the details. Be empowered as a learner.

When it comes to preparing, most are following @theCMEguy’s blog post suggestions, particularly going through the abstracts and making a list of first-, second-, and third-tier choices for each time slot; and setting up meetings. Being a bit of a techno-geeky group, we’re also loading up on apps, such as Tweetchat and Streamboard for meeting tweets, setting a time for an in-person tweetup (Monday at 6 pm), debating whether to tweet to the main #acehp12 hashtag or use the session-specific identifiers (use both as separate hashtags I believe was the consensus), and placing wagers on the total number of tweets to come out of the conference this year.

But just going through the abstracts doesn’t necessarily mean you’re going to get what you need. How do you find out which sessions may have sounded better on paper than in reality and vice versa? Some rely on the Twitter stream for thumb-ups and –downs. Others hover in the doorway before committing to a session. Others rely on tried-and-true presenters who they know will do a good session, though I personally am always torn between going to a session whose faculty I know is great and looking for the fresh voices and fresh ideas that this community needs to hear.

The sessions people are looking forward to most seemed to depend mostly on whatever their biggest challenges are, from performance-improvement CME to updates from the Accreditation Council for CME to anything to do with grants. The on-site technology help station also is getting some interest from folks, as are technology sessions. What we all hope to get out of the conference varied too, with one recently unemployed poster looking to network and the rest of us hoping to rustle him up a job. Others are looking to make new contacts, and learn more about MOC/MOL, future trends, grants, and technology.

Among our collective goals for this year’s conference?

* Spend at least one meal as a mentor and at least one meal as a mentee.

* Find new ideas, fresh voices, and better ways of doing things. Make connections, learn, speak, share.

* Spend at least one session sitting next to someone you’ve never met.

* Spend more time at meals downstairs than up in your room checking e-mail.

• Participate! Engage, share, be an active learner.

I hope to see you in Orlando!

One thing that seemed to be of huge concern was the idea that exhibitors were going to start asking them to provide physician attendees’ National Provider Identification numbers. Since this is public information, I’m having a hard time understanding why that is the meeting planner’s problem—why can’t the exhibitors just look them up? If someone can explain why this is potentially a big issue for exhibitors, please let me know. I tried to find out from a few folks after the session ended, but everyone was in a rush to leave so I didn’t really get much other than if an exhibitor demands it, it’s their problem. Which I get, but I don’t get why exhibitors would demand this from them. Light-shedding on this would be welcome!

Other big issues were the costs of complying with government regulations and Accreditation Council for CME rules, pressures to find new sources of revenue, building traffic to the exhibition floor, international initiatives (including visa-related challenges), CME credit interchange with other countries, and all the various codes and rules and regulations they are supposed to follow nowadays.

One participant was particularly concerned about the Council of Medical Specialty Societies’ newish ethical code that is designed to limit drug and device company influence over patient care. While similar in many ways to the ACCME’s Standards for Commercial Support, it also prohibits society presidents, CEOs, and editors-in-chief of society journals from having direct financial relationships with relevant for-profit companies in the healthcare sector. One participant said her organization actually had to ask one of its journal editors to resign after her society agreed to abide by the CMSS code.

Sponsorships and exhibit dollars on the decline had most of the crowd at least someone frazzled. As one person said, “With the PhRMA Code, they don’t want to sponsor anything anymore.” Several said their organizations were going the same route as PCMA, offering year-round sponsorships that extend far beyond the meeting rather than providing one-offs on tote bags and banners. (Note: This article offers some good tips on how to get more sponsorship dollars. And here’s another one.) One thing sponsors particularly seem to like, said some participants, is being able to meet with board members and other influential people in the industry at board and other high-level meetings. Some said they give preferential treatment on the show floor to exhibitors that are also in more extensive sponsorship relationships, others said they kept it completely separate.

From what people were saying, I’m not sure they’d buy into this snip of research finding that physicians aren’t eschewing the trade show floor now that the tchotches are out due to PhRMA Code restrictions. It sounds like, for medical meetings as for other types of association conferences, it’s becoming more and more of a push to get people on the show floor and interacting with exhibitors. While product theaters can help, they don’t appear to be a major solution to the exhibition drain problem. As one person said, “The surveys say they value exhibitions, but they don’t go. We give them food, product theaters, we’re even putting the reception on the show floor. Nothing seems to help.”

One said she was going to take the “continue the conversation” idea from PCMA, where a follow-on informal session is held after a keynote so those who want to can dive deeper into the material, only hold it on the show floor. Which is fine, as long as it isn’t for credit, warned another person. Another pointed to a different angle on the problem: Maybe it’s the booths that aren’t so attractive. So that organization offers a consultant who can evaluate exhibitor booths and suggest ways to improve them.

Some said they had added a virtual trade show component as a complement to repurposing educational content from the conference for online distribution, but it didn’t appear that the value was all that high (one said that only 42 percent of virtual attendees visited the virtual exhibit, which I thought actually sounded pretty good. Another said it was more like 25 percent for his group). Streaming the educational session, with or without CME credit attached, live and archived, seemed to be pretty popular among attendees of most of the planners who said they had done it. However, interest dropped off a cliff when members were asked if they would pay for it, one person said (shocking, I know!). Another said she had a good response to charging one fee to get access to all the content, and an additional fee on top of it if they wanted to get CME credit for it.

They didn’t talk a lot about CME educational grants, but one person did point out that, now that pharma budgets for CME grants are shrinking, their ad budgets actually are growing. Accordingly, medical organizations are beginning to put more of their focus on attracting those ad dollars to support the overhead for their meetings.

There was more—a lot more—but I’ll leave this one with two of the wildest promotional ploys I’ve heard of:

One was a company that brought colored chalk and proceeded to draw its logo on the sidewalk in front of the medical conference’s headquarters hotel. Another person told of a company that put its logo on the mainsail of a big sailboat and had it sail up and down the harbor in view of the meeting (I’m not sure if this was in San Diego, but I could see it happening there.)

Note: This is cross-posted at the face2face blog.

This quote at the end of the article is really interesting, I thought: [Stephen Smith, chief strategist, MDLinx] called the perceptions of lesser quality an unintended consequence of the increase in regulation on pharmaceutical companies’ communications and their resulting pull-out from CME. “We’ve squeezed everything toward mediocrity to prevent abuses.”

From a pharmaceutical/device meeting manager’s perspective (which I got last week in spades, being surrounded by these good folks), no one seemed to be anticipating it making much of a difference in their lives. The biggest issue for them was CMS’s delaying the collection of data on physician spend from Jan. 1, 2012, until after final regulations are issued.

I heard over and over again that if they weren’t already tracking physician and other healthcare worker spend as a requirement of a corporate integrity agreement, they have been working since healthcare reform passed to get a system up and running. In fact, a survey of the forum’s participants found that 88 percent had a system already to track their spend on physicians and other healthcare professionals, and 76 percent were either already testing their system or were confident that their system was ready to roll with the new year.

But that’s about as far as I’ve had time to get with CMS’ announcement. I’m not sure whether it’s a blessing (so thankful someone’s keeping on top of all this!) or a curse (ain’t no way I can keep up with the flow of information the dude puts out, much less beat him to the punch, so I have to live with being continually scooped!), but Tom Sullivan has been churning and burning all this up on his Policy and Medicine blog. Keep in mind that he comes at it from a pro-collaboration perspective, but he provides a great overview of possible affects this announcement could have on the CME community. Some posts to check out:

Physician Payment Sunshine Act: CMS Proposed Rule - Impact on Continuing Medical Education, Medical Societies and Patient Organizations

Physician Payment Sunshine Act: CMS Proposed Regulations — Public Posting, Data Submission and Correction

Physician Payment Sunshine Act: CMS Proposed Regulations Delayed Reporting for Clinical Trials, Penalties and Preemption

Physician Payment Sunshine Act: CMS Proposed Regulations – The Cost for Sunshine

Physician Payment Sunshine Act: CMS Proposed Rule Overview

Physician Payment Sunshine Act: CMS Releases Proposed Regulations

Update:Daniel Carlat, MD, has a different take on how the new rules could affect CME (namely, he’s ecstatic that the language could include faculty honoraria in reportable income) on his Carlat Psychiatry blog.