Professional medical associations (PMAs) provide continuing medical education (CME) to their membership through various avenues. They have the expertise and content to deliver the education their members seek and utilize to provide optimal care. One major vehicle is the annual meeting.

Education and the annual meetings continuously evolve and change to provide pertinent educational content to providers. A significant focus has been on new technology, advancements, and procedures. Outcomes and efficacy are also critical. Experts have been utilized, thereby providing invaluable firsthand information.

Disclosure and conflict of interest policies are implemented to ensure the audience is provided with appropriate information allowing informed interpretation of the presentation. In addition to conflict-of-interest policies and disclosure, the presentations are balanced, presenting various perspectives. PMA meetings have undergone significant changes over the years and will continue to evolve. The goal will always be to educate the membership. Additional changes will be coming due to new Accreditation Council for Continuing Medical Education (ACCME) requirements.

Recent changes implemented by the ACCME will require changes to PMAs annual meetings to qualify for continuing CME accreditation. These affect PMAs annual meetings in several ways — planning, budgeting, content, disclosures, and reporting data afterwards. The most impactful change is about speakers with interests in private companies.

The changes affect how faculty are selected, vetted, and monitored. Faculty, planners, and anyone involved in content development must now disclose all financial relationships with ineligible companies from the prior 24 months, regardless of perceived relevance. This expands beyond the previous 12-month model with responsibility for determining relevance by the accredited provider’s disclosure review team.

Speaker eligibility includes strict exclusions for owners/employees of ineligible companies. Owners or employees of ineligible companies cannot participate as planners or speakers unless specific exceptions apply. This includes any private equity owners, founders or executives of startups, even if not publicly traded.

Experts within the industry (sometimes referred to as Key Opinion Leaders or KOLs) may now be excluded from the ability to provide CME presentations. It is no longer sufficient to have a balanced presentation. Previously, many of these presenters were able to provide a disclosure which allowed the audience to be informed of any relationships or possible conflicts that may be relevant to the presentation. Most CME sessions also had additional presenters with an alternative and even opposing viewpoint to provide for a balanced forum.

With the ACCME changes, a disclosure is no longer sufficient. A balanced presentation is no longer sufficient. There are numerous steps that organizations must undertake to mitigate the risk of bias. This comes with significant administrative burden including added documentation and added administrative time and resources. The mitigation requirements may include release of financial information from the presenters that presenters may not be comfortable disclosing. Despite all the mitigation efforts and steps taken to present a balanced presentation, many KOLs will not be able to take part in CME events going forward.

Presentation content may also have to be modified or restricted to remain compliant with ACCME requirements. Specific products, logos, branding and even mention of ineligible companies are not allowed during presentations. This could present difficulties for presenters to discuss the most up-to-date technologies and developments on the horizon. Every organization must ensure that there is no bias or promotional content included in any presentation. All content must be neutral and evidence based. These regulations are not only for in-person meetings, but also for Virtual CMEs. All areas of continuing medical education will be affected.

Although the new ACCME standards may present positive outcomes in increased transparency, trust, separation of industry influence and consistent standards across formats, there are many challenges that accompany these changes.

What will be the impact of these additional requirements and how will members be educated? What will annual meetings look like? Will CME presentations need to be more generic and lack real-world examples or case studies? Will presenters be speakers with less expertise? Will PMAs, including NASS, run “non-accredited” presentations which are unable to afford CME?  Will meetings have limited CME sessions covering new technologies and cutting-edge research? Will non-CME become more important than CME?

NASS will continue to educate members and provide the latest information to its membership. We will follow the ACCME requirements and continue to provide CME to our members. However, we will also provide non-CME education to ensure members have access to the latest information which they can use to continue to provide optimal care.

NASS will continue to embrace new technology and the latest advancements in spine care and share with our membership accordingly. NASS will embrace these new requirements from ACCME as an opportunity.