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May 20, 2008

Macy Report -- Filled in the Blanks

The Macy Foundation published their full proceedings of the conference Continuing Education in the Health Professions:  Improving Healthcare through Lifelong Learning, six months after the initial release of the Macy Foundation’s controversial Chairman’s Conference Summary.

They filled in the blanks with two reports in one: 

A)   Report on how to improve continuing education in the health professions

B)   Report on why continuing education should live free of the burden of raising money for their activities and other encumbrances such as competition from private education companies.

The document opens with a letter from the Macy Foundation President, June Osborn, MD, who seems like a very kind person and who was convinced to do the conference by Susan Fletcher, MD.  She is retiring this year and wanted to go out with memorable report. Susan wrote a note about how she desires that this report is very influential and pontificated. She wanted to repeat the Flexner Report of 1911, a tall undertaking, given they had only three days in Bermuda to do it.

The conference summary (previously released) which we have written on extensively about (Macy Report -- The World is Flat, and Macy Foundation Conference Summary – Tip of the Iceberg?). Not sure how you summarize something that is not done, but they had an IOM event to present this at.

The two reports are:

Report A) Approaches to knowledge development – what works and what does not.

With the exception of the Up-to-date commercial in the middle (no product messages here).  The report goes into detail on how physicians learn and what questions we should be asking ourselves the stuff of good education.

Report B) Financing Continuing Education: Who, How and Why

They go into great detail on the breakdown of finances of CME programs. Some of their figures are based on how they chose to do the math, as opposed to actual figures.  Much of this is a re-hash of old arguments on why physicians should avoid any contact with industry.

They ended up with a discussion on how to change the system of learning, and a lot of this is good stuff.  It is a shame that on one hand they say – look what we could do with additional resources and on the other we despise the resources we have.

Couple of thoughts…

I spoke with one of the chapter writers yesterday and they were clear that

·         Many of the attendees were not in agreement with the anti-industry sentiments and tone of the program.

·         The chairman and steering committee had a pre-determined anti-industry agenda and were not going to deviate from that agenda.

·         This document is really just a report about what happened at their meeting in Bermuda, plus some additional work.

·         The prestigious list at the end of the document are the list of those who attended the meeting, (kind of like this is a list of who attended the any meeting that broke up into working groups) nothing more than that.

Ultimately, it is doubtful it will have the same effect as the Flexner report on Medical Education -- the seminal event that Susan Fletcher, MD was hoping for. 

We need to keep in mind that it is the prerogative of academia to pontificate about their vision of utopia.  Bermuda must have been a great place to do it.

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