Percentage of In-Person Medical Education Events Surpass Online CME Programs

RESEARCH TRIANGLE PARK, NC--(Marketwired - August 22, 2017) - All surveyed US medical affairs teams dedicate on average over 65% of their continuing medical education (CME) funding to a mixture of small, mid-size and large in-person programs, according to a study by pharmaceutical intelligence provider, Cutting Edge Information.

Data recently published in the study, Medical Education: Innovating CME to Improve Patient Outcomes, revealed that both US and global medical affairs teams expend approximately 30% of their budget on average for online one-way and online interactive CME programs.

Interestingly, one US team at a Top 50 company dedicate 5% of its CME funding in favor of print or monograph forms of medical education – no other team supports these programs.

"The way teams decide which medical education programs to fund depends largely on the audiences they hope to reach," said Natalie DeMasi, research team leader at Cutting Edge Information. "While aggregate CME data highlight the value of online platforms, individual physician preferences indicate that in-person meetings also remain important."

At the country level, surveyed medical affairs teams in Latin America and the Asia-Pacific regions supporting blockbuster products dedicate up to 60% of their total CME funding to support large-scale, in-person events. Several other surveyed Top 10 country-level teams dedicate only 5% of their CME funding to support online one-way programs, the study found.

Medical Education: Innovating CME to Improve Patient Outcomes, available online at, includes detailed metrics, best practices and insights into four main areas of medical education:

Unaccredited, company-driven medical education
Independent medical education (IME) grants
Speaker recruitment
Speaker training

This report examines medical education investments and staffing resources, as well as activities, trends, and event planning approaches. It highlights new, exciting ways that teams are elevating the value of medical education.

For more information about Cutting Edge Information's medical affairs and medical education industry research, visit

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Doctor Shortage Under Obamacare? It Didn’t Happen


When you have a health problem, your first stop is probably to your primary care doctor. If you’ve found it harder to see your doctor in recent years, you could be tempted to blame the Affordable Care Act. As the health law sought to solve one problem, access to affordable health insurance, it risked creating another: too few primary care doctors to meet the surge in appointment requests from the newly insured.

Studies published just before the 2014 coverage expansion predicted a demand for millions more annual primary care appointments, requiring thousands of new primary care providers just to keep up. But a more recent study suggests primary care appointment availability may not have suffered as much as expected.

The study, published in April in JAMA Internal Medicine, found that across 10 states, primary care appointment availability for Medicaid enrollees increased since the Affordable Care Act’s coverage expansions went into effect. For privately insured patients, appointment availability held steady. All of the gains in access to care for Medicaid enrollees were concentrated in states that expanded Medicaid coverage. For instance, in Illinois 20 percent more primary care physicians accepted Medicaid after expansion than before it. Gains in Iowa and Pennsylvania were lower, but still substantial: 8 percent and 7 percent.

Though these findings are consistent with other research, including a study of Medicaid expansion in Michigan, they are contrary to intuition. In places where coverage gains were larger — in Medicaid expansion states — primary care appointment availability grew more.

“Given the duration of medical education, it’s not likely that thousands of new primary care practitioners entered the field in a few years to meet surging demand,” said the Penn health economist Daniel Polsky, the lead author on the study. There are other ways doctor’s offices can accommodate more patients, he added.

One way is by booking appointment requests further out, extending waiting times. The study findings bear this out. Waiting times increased for both Medicaid and privately insured patients. For example, the proportion of privately insured patients having to wait at least 30 days for an appointment grew to 10.5 percent from 7.1 percent.

The study assessed appointment availability and wait times, both before the 2014 coverage expansion and in 2016, using so-called secret shoppers. In this approach, people pretending to be patients with different characteristics — in this case with either Medicaid or private coverage — call doctor’s offices seeking appointments.

Improvement in Medicaid enrollees’ ability to obtain appointments may come as a surprise. Of all insurance types, Medicaid is the least likely to be accepted by physicians because it tends to pay the lowest rates. But some provisions of the Affordable Care Act may have enhanced Medicaid enrollees’ ability to obtain primary care.

The law increased Medicaid payments to primary care providers to Medicare levels in 2013 and 2014 with federal funding. Some states extended that enhanced payment level with state funding for subsequent years, but the study found higher rates of doctors’ acceptance of Medicaid even in states that didn’t do so.

The Affordable Care Act also included funding that fueled expansion of federally qualified health centers, which provide health care to patients regardless of ability to pay. Because these centers operate in low-income areas that are more likely to have greater concentrations of Medicaid enrollees, this expansion may have improved their access to care.

Other trends in medical practice might have aided in meeting growing appointment demand. “The practice and organization of medical care has been dynamic in recent years, and that could partly explain our results,” Mr. Polsky said. “For example, if patient panels are better managed by larger organizations, the trend towards consolidation could absorb some of the increased demand.”

Although the exact explanation is uncertain, what is clear is that the primary care system has not been overwhelmed by coverage expansion. Waiting times have gone up, but the ability of Medicaid patients to get appointments has improved, with no degradation in that aspect for privately insured patients.

To study anatomy, Travancore king got made ivory skeleton in 1853

Thiruvananthapuram, August 6

At a time when western treatment methods were not popular here, a ruler of the erstwhile princely state of Travancore got a human skeleton carved out of ivory to study anatomy and osteology over a century ago.

As social customs barred him from "touching" corpses and bones, Uthram Thirunal Marthanda Varma, the then King, who had a great affinity for English medicines and treatment system, got the replica of human skeleton made from ivory in 1853.

Created by a craftsman from Travancore, the skeleton, having astonishing similarity with original human skeleton and impeccable perfection in its measures, is now kept on display at the Natural History Museum on the zoo campus here.

Museum authorities say that a research is underway to ascertain the identity of the skilled craftsman who carved the ivory skeleton with "so much precision and still remains an unsung hero in the annals of history".

The museum's records showed that the model was "executed in 1853 by local workmen under commands of His Highness Uthram Thirunal Marthanda Varma Maharaja for scientific study".

The younger brother of visionary King Swathy Thirunal, Uthram Thirunal, who had ruled Travancore during AD 1846-60, had a great fancy for the European style, fashion, dress, occupation, furniture, amusements, medicines and treatment system since infancy.

According to historian Malayinkeezhu Gopalakrishnan, the ivory skeleton can be viewed as a monument of the evolution and spread of the English treatment system and medicines in the tiny princely state.

It can also be viewed as a fine example of Travancore's exemplary legacy in ivory craftsmanship which had even amused the British, he said.

"Uthram Thirunal is considered as the person who had popularised the English treatment system in Travancore ... He had devoted great time in studying the medical science and imported medicines and latest medical devices from England and other parts," Gopalakrishnan told PTI.

"However, the prevailing social customs had created hurdles for him to pursue his interest to study human anatomy and osteology ... To overcome the obstacle and continue his study, he had got made this ivory skeleton," he said.

It is believed that the skeleton was sculpted based on an actual skeleton, brought from Madras, he said.
Natural History Museum Superintendent S Abu said the ivory skeleton has always kindled a special interest among doctors and medical experts who visit the museum.

"The ivory skeleton was made in such a meticulous way..
experts see it as an excellent mix of science and craftsmanship ... We are now on a mission to figure out the unidentified craftsman who created this," he told PTI.

It is expected to be highly helpful for the posterity in studying the history and legacy of Travancore, the official said.
Besides the ivory skeleton, the historical records also showed several other examples of Uthram Thirunal's interest and knowledge in the Western treatment system and its practice.

Travancore Diwan Peishcar, P Shungoonny Menon recorded that Uthram Thirunal had even run a private dispensary, where he treated people, carried out minor surgical operations, vaccinated his palace attendants with his own hands and distributed English medicines when he was the 'elaya raja' (prince).

He also set up a laboratory which had various apparatus and chemicals purchased from other parts of the globe, the records said.

In his book "A History of Travancore," Menon noted that his friendship with the then residency surgeon, Dr Brown, had helped 'elaya raja' study medical science.

"His Highness was inclined towards studying the doctor's profession and seeing the intelligence and aptitude of the prince, that gentleman (Dr Brown) most willingly undertook to teach the science of medicine to this knowledge-seeking scion of royalty; and in the course of this study, the cognate branches of chemistry and anatomy was also taught," he said.

Even after Dr Brown left for England after some time, the prince indulged in self-study by procuring and reading the works of eminent authors.

Records showed that he procured medicines from Durbar physician's dispensary and used for treating his own attendants and their families.

He also placed orders for medicines from the Madras and Bombay presidencies and brought it from even England, it said.

"Every new medicine, discovered and advertised in the newspapers, was procured and in the course of a few years, a large room, which had been converted into a private dispensary being found insufficient, a separate building was constructed on an enlarged scale to provide the necessary accommodation," Menon said.

The arrangements at the dispensary won the admiration of even Europeans.

With the prince spending a large amount of time at his dispensary, people, especially belonging to the Hindu community, preferred this institution to government charity hospital.

Royal's dispensary

It is interesting to note that though upper class Namboothiri Brahmins would not even touch English medicines under the idea that most of the liquid substance contained spirits, they began to take them freely from the prince's dispensary.

Brahmins, who visited Travancore as part of various religious ceremonies, spread the news of the prince's medical knowledge and the virtues and effectiveness of European medicines in Malabar (north Kerala) and other neighbouring princely states.

The royal's dispensary was the only resort of outside state Brahmins for medical aid while coming for Murajapam, an auspicious ritual conducted in Sree Padmanabha Swamy Temple here every six years.

Records also showed that Utram Thirunal successfully treated his brother and the then king Swathy Thirunal, when he suffered from diarrhoea.

A three-month-long treatment under him also cured the chronic dyspepsia of a 'Gouda Brahmin Sastri', who came here for Murajapam from Benaras, it said.

The prince's laboratory had glass retorts, boilers, evaporating dishes, crucibles of different kinds, and many other things necessary for conducting chemical experiments.

There was also a powerful electric machine, a galvanic battery, an air pump, an ice-making machine besides several kinds of optical instrument, such as stereoscopes of various sorts, telescopes of sizes and opera glasses, it added. — PTI

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Medical education: MBBS admission confusion persists

Thiruvananthapuram: Though the Commissioner for Entrance Examinations (CEE) announced that Rs 5 lakh would be the annual fee for 85 per cent MBBS seats in self-financing medical colleges, confusion prevails as the option registration ends on August 16. The fee for most of the colleges barring three — Academy of Medical Science, Pariyaram; MES Medical College Perinthalmanna, Dr Somervell Memorial CSI Medical College, Karakonam — have the same fee of Rs 5 lakh for the 85 per cent seats. But the students have been asked to submit separate options for both the government and management quotas, creating doubts among students over their choice.

Those who got allotted to 35 per cent management seats in the other three that had entered into a deal with the government are liable to pay an interest-free refundable deposit of Rs 11 lakh in addition to the fees as per the agreement. Similarly, the 15-per cent NRI allottees are liable to pay an interest-free refundable deposit of Rs 15 lakh. Moreover, both have to produce a bank guarantee on the fee for the remaining four years, the CEE clarifies through a separate order contradictory to the earlier one.

Of the 50 per cent government quota, 14 per cent will be for BPL/lower income group attracting a fee of Rs 25,000, while 26 per cent SEBC quota fee is Rs 45,000 and the rest Rs 2.5 lakh. As a seat in the 35 percent management quota costs Rs 11 lakh and 15 percent NRI seats Rs 14 lakh annually. In these two private colleges and the state-supported Pariyaram college, students under the management quota will have to remit Rs 5 lakh and should produce bank guarantee for the remaining amount. The order says all fees are ‘provisional’ and will be subject to the decision of the High Court considering writ petitions and students are liable to pay the enhanced fee if the court decides so.

Medicine in the media: stories about studies are creating chaos

The varying result of medical studies results can make catchy headlines.

For any given topic of scientific inquiry, the pharmaceutical industry may conduct hundreds of studies, and, because of this, some variance in results can occur.

With an estimated 1m statin prescriptions given each week, there is a controversial front page story on their use almost as often.

The Daily Mail, the UK’s most popular tabloid, is a serial offender.

The newspaper, citing expert opinions and scientific studies, published an article in November last year suggesting that the expert consensus is that statins are a waste of time and fail to reduce the risk of heart disease.

It published another negative article on statins in April this year, suggesting that their side-effects outweight the benefits.

Just a few months later, on 28 July, the newspaper posted a story outlining the potential for statins to help 2.5m people with kidney disease, owing to their efficacy in treating high cholesterol and heart disease.

The difference between the negative and positive articles was that the findings in the latter were backed by Nice, an independent public body that provides guidance on health and social care.

Nice reaches its decisions after considering all relevant research and scientific data, using research techniques such as meta-analysis, and appraising research designs to check for flaws that may bias results.

The articles describing statins as a “waste of time” relied on weaker evidence, gained from a single study and the opinion of experts, rather than tried-and-tested research methodologies.

The public effect

Using a drug as it’s prescribed is important and if those that need it question its effectiveness or even doubt its safety.

With the public understandably uncertain about which stories to believe the drug is more likely to not take it correctly and we can see this happening in the past.

Following the measles, mumps and rubella vaccination controversy, a qualitative study found that parents were unsure who to trust regarding health information, with perceptions that politicians and doctors were untrustworthy.

To improve how news is conveyed, the pharmaceutical industry needs to rely more on specific information, such as that gained from regulatory bodies and meta-analysis results.

This means giving less coverage to controversial single studies until a census has been formed or the study has been replicated a number of times with a degree of similarity in the results.

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