Reality check needed for CME credits

There is an ongoing concern in Canada and the United States that standards of education are falling. At a grassroots level we have seen a rise in the number of independent schools that focus on basic tasks such as reading, composition, and math. On a broader level, the business community (including Microsoft chairman, Bill Gates[1]) has expressed concern that a decline in science skills[2] will cause North America to lose its innovative and economic edge[3]

The National Science Foundation (NSF), an independent US Federal Agency, was created in 1950 “to promote the progress of science, to advance the national health, prosperity, and welfare….” It funds roughly one-fifth of all basic science research in the US and plays a major role in science education. 

As part of their role in promoting basic science knowledge, the NSF regularly polls the American public regarding their understanding of scientific issues. Followers of comedian Rick Mercer will find no surprises in their 2002 survey’s finding that large numbers of Americans believe in ghosts (38%), ESP (50%), and astrology (28%).[4] 

The NSF report also makes specific mention of public acceptance of alternative medicine, including homeopathy, energy therapies, and psychic healing (53%), and the harm caused by such pseudoscientific practices. Contrary to the common claim that acceptance of alternative medicine tends to slightly correlate with higher education, the NSF report identified a much more relevant trend—namely that higher levels of science education result in substantially lower levels of acceptance of pseudoscientific beliefs. 

At first blush, belief in astrology, psychic healing, and alternative medicine may seem innocuous, especially if real doctors are just around the corner to bail you out of trouble. But it is conceivable that such misinformation could have adverse effects for public health. There is, for example, a considerable body of literature documenting the opposition among alternative medicine providers to vaccines.[5-7]

However, while parents, national scientific bodies, and even the business community speak of a need for better understanding of scientific issues, there may be room for the medical community to examine its own house.

In the summer of 2005, a conference called When the Body Forgets to Heal was held in Victoria.[8] 

Typical examples of talks offered included Energy Healing: Morphogenetic Fields; Talking Circle; Holotropic Breathing and the Shamanic State of Consciousness (participants were requested to “… bring a sacred object or special photograph, drum or rattle, pillow and blanket and wear light clothing”); Reversing AIDS With Nutrition; the Use of Ozone in Medicine (the program stated that in Japan, cancer is being treated by injecting ozone directly into the tumor); and Immune System Dysfunction: the Homeopathic Approach to Chaos. 

Perhaps the most interesting speaker was a teenage boy named Adam Dreamhealer, who was billed as a gifted distant energy healer. The program offered this explanation of his powers: “… our minds, through intention, directly affect our immune systems, guiding us in fine-tuning our own skills in directing energy to re-establish health, as we seek to achieve a higher level of consciousness. The academic theories of quantum physics come to life with [Adam’s] accounts of his direct experience of the interconnectedness we all share. Adam has the ability to perceive this connectivity and influence it over any distance instantaneously, accomplishing distant healing.”

While it is of interest that the list of above topics dovetails neatly with the concerns raised in the NSF report, it will undoubtedly surprise some that CME credits were awarded for attending. Far from being an isolated example, a more recent conference offering a seminar on the use of homeopathy as a treatment for epidemic influenza was also accredited.[9]

Some people might wonder if that type of material can be accredited, what wouldn’t be?

It’s fair to ask whether granting CME credits should be tied to some sort of quality control. Typically, physicians and scientists implement their own quality control—a “reality check” to ensure that educational material is as accurate and scientific as possible.

We feel that CME is no exception. Bodies entrusted with medical education should ensure that the process for approval includes standards to make certain the profession and the public get information about truly effective health therapies.

—Lloyd Oppel, MD, MHSc, FCFP(Em)
Chair, Alternative Therapies and 
Allied Health Committee

References

1. C|Net News. Gates: Get U.S. schools in order, 2005. http://news.com.com/Gates+Get+U.S.+schools+in+order/2100-1022_3-5692845.html (accessed 19 February 2007).
2. Public Agenda. International Science Scores, 2003. www.publicagenda.org/issues/factfiles_detail.cfm?issue_type=education&list=13 (accessed 19 February 2007).
3. Business Roundtable. Citing “Critical Situation” in Science and Math, Business Groups Urge Approval of New National Agenda for Innovation, 2005. www.businessroundtable.org/newsroom/document.aspx?qs=5876BF807822B0F1AD1448722FB51711FCF50C8 (accessed 18 February 2007).
4. National Science Board. Science and Engineering Indicators—2002. Arlington, VA: National Science Foundation; 2002:7,36,39.
5. Ernst E. The attitude against immunisation within some branches of complementary medicine. Eur Pediatr 1997;156:513-515. PubMed Citation Full Text
6. Spigelblatt L. Homeopathy in the paediatric population. Paediatr Child Health 2005;10:173-177. 
7. Wilson K, Mills E, Boon H, et al. A survey of attitudes towards paediatric vaccinations amongst Canadian naturopathic students. Vaccine 2004;22:329-334. PubMed Abstract Full Text
8. Association of Complementary and Integrative Physicians of BC, www.bodyheals.ca, 2005 Program (accessed 19 February 2007).
9. The Holistic Research Foundation of Canada. The Immunity Challenge, 2006. www.immunitychallenge.ca/immunity.php (accessed 19 February 2007).