First, some self-declarations. Since 1992 I have benefited financially from in-office sales of dietary supplements via the integrative medical practice of my spouse. On multiple occasions over 30 years, I have helped mount or been associated with medical conferences in which the business model relied on exhibits from dietary supplements companies. I have in multiple instances secured grants from natural products companies to support initiatives of various professional organizations, research projects, and for The Integrator Blog. Such relationship are often the rule across the functional, naturopathic, integrative, chiropractic and traditional Chinese medicine communities. What’s new now is that those involved in integrative and functional medicine continuing medical education are increasingly in the spotlight of the Accreditation Council for Continuing Medical Education (ACCME) via new application of old rules, and new ACCME rules under consideration. These may – for better and for worse – shake-up the way integrative CME is offered, and potentially not only for medical doctors.
After publishing on challenges the Accreditation Council for Continuing Medical Education (ACCME) is presenting to the integrative and functional medicine continuing medical education (CME) providers, I sent links to Graham McMahon, MD, MMSc, the organization’s president and CEO to request an interview. Multiple integrative CME providers with decades delivering integrative CME have lost or are facing potential loss of recognition. They have shared serious questions of transparency and intent on ACCME’s part. Some efforts to connect with ACCME have been rebuffed. Is integrative medicine being targeted? In my request for an interview, I provided McMahon some background on concerns. McMahon responded immediately, and affirmatively. We spoke for over 30 minutes via zoom on February 5, 2020. His responses included a surprising assertion that he believes the present ACCME is aligned with integrative medicine principles and practices. He committed to open dialogue in ACCME’s move “from cop to coach.” He underscored that the new proposed language is yet open for comment. I assembled our exchange in the following interview format and sought his edits and written replies to additional questions, then secured his approval prior to publication.
Should accredited continuing medical education providers for integrative medicine be prohibited from training medical doctors to practice integrative modalities that aren’t “generally accepted within the profession of medicine as appropriate for the care of patients”? What impact might this have on efforts – for instance – to shift chronic pain treatment toward non-pharmacologic approaches that most of medicine doesn’t “generally” include? Might giving arbiters of science in a disease model this power put the brakes on efforts to shift clinical care from managing disease to creating health? These other significant questions are on the table for the integrative health field as the Accreditation Council for Continuing Medical Education (ACCME) posts its draft revision of accreditation standards. The changes, targeting issues throughout CME, have particular challenges for the integrative medicine field. The comment period closes February 21, 2020.
Prior to publication of my article on the proposed new standards on “content validity” from the Accreditation Commission for Continuing Medical Education (ACCME), I circulated it to a few leaders in the field for comments. In the process, I learned that a team from the Academic Consortium for Integrative Medicine and Health (“the Consortium”) recently had a conference call with Graham McMahon, MD, MMSc, ACCME president and chief executive officer. Saturday morning, January 25, 2020 I spoke with Rick Hecht, MD, the Consortium chair, who was part of the conference cal. He has had other recent discussions with key colleagues in the CME office of his home institution. Hecht’s comments offer some perspective on ACCME’s current areas of focus in CME. I have assembled his comments in the following interview format and secured his approval prior to publication.