As Kari Fay, MD, navigated nerves ahead of delivering a CME talk at this year’s TexMed, one of the Texas Medical Association’s annual conferences, a leadership-themed CME was getting underway in another hotel ballroom down the same corridor.
Absent the scheduling conflict, Dr. Fay says she would have loved to attend “Confidence in the White Coat: Addressing Impostor Syndrome Among Emerging Medical Leaders,” given by a fellow physician.
Dr. Fay said she went into her CME talk “afraid, very much with impostor syndrome. I went into it thinking oh no, they’re going to sit there and go how come they picked her to do this, or I was going to be challenged throughout it” with difficult questions and pushback.
“But it was actually an incredibly warm, supportive environment, where I felt like we fostered a lot of discussion. It was a great experience.”
With a cyclically refreshed selection of about 100 on-demand programs available at any time in TMA’s Education Center, CME developed and transmitted by TMA undergoes a rigorous vetting process informed by physician input and expertise. Conference talks on timely topics complement enduring materials that span health information technology (HIT) and augmented intelligence (AI), physician health and wellness, and public health.
Regardless of format, CMEs on those topics are developed or delivered by member physicians and TMA staff in response to needs and knowledge gaps identified by leadership from TMA’s boards, councils, and committees and through policy generated by the House of Delegates.
Dr. Fay’s talk at TexMed, “Talking and Treatment for Menopausal Symptoms,” included an overview of hormone therapy that offered an evidence-based counterpoint to some of the prevailing, polarized discourse she described as either fearmongering or exalting the therapy as a cure-all fountain of youth.
“I think neither one of those things are true,” said Dr. Fay, an obstetrician-gynecologist in New Braunfels and member of TMA’s Committee on Reproductive, Women’s, and Perinatal Health. “There’s no peer review of what people are getting in their social media feeds and what they’re seeing online.”
As some of the silence around menopause has lifted, with celebrities hawking products that purport to ease its symptoms, the zeitgeist has permeated Dr. Fay’s practice. “Five, six, seven times a day, I have a patient who is complaining of perimenopausal symptoms, and this is incredibly popular right now in pop culture and social media. So it has very much pervaded my clinic day.”
With her post-Women’s Health Initiative medical residency cohort largely being left to their own devices to figure out menopause management strategies for their patients, Dr. Fay expected a significant subset of physicians might feel suboptimally equipped to face a deluge of similar patient queries from women in midlife. She thought a roadmap of sorts via CME might be helpful.
“I felt like the general OB-gyn would benefit from extra [training]: This is what my personal journey in treating menopause has been. And then also for a lot of primary care physicians, family practice doctors, [and] internal medicine doctors who are seeing lots and lots of middle-aged women – what would help them, the basic workup, the basic risks, benefits, options for treatment, and what the current standard of care is.”
Crafting CME content can help physicians revisit or add to their training, too, Dr. Fay says.
“When I was developing this, it made me really look back and say, ‘well I always say this to my patients – why do I say this or am I really saying the right thing or is there – why do I do it this way?’” she said. “It makes you really reexamine your day-to-day practices and make sure you are following up-to-date, evidence-based medicine.
“We always say ‘watch one, do one, teach one’ to really know how to do something. This is the teach one.”
Physician input grounds the talk
Cheryl Krhovjak, director of TMA’s Education Center, coordinates CME development with TMA leadership.
“Any of our talks that are clinical are 100% driven by one of our physician members,” she said. “We offer PDFs, we offer on-demand webinars, and then we offer CME to Go, which is run through our podcast channel. Our younger physicians and students were telling us they wanted really quick, short CMEs, so that’s how we’re meeting that need.”
In a CME to Go podcast, Rehan Ahmed, MD, presented with Shannon Vogel, TMA’s associate vice president of HIT, for “AI in Health Care: A Doctor’s Perspective on Getting Started.” The TMA “Practice Well” episode was based on a talk the Bellaire ophthalmologist delivered at TMA’s 2024 Business of Medicine Conference.
Dr. Ahmed, a consultant to TMA’s Committee on HIT and AI, posits with the ambivalence many physicians feel around augmented intelligence, physician-led CME on the topic establishes credibility and instills comfort.
That combination can support physicians hesitant to dip a toe in large language model waters, something he encourages in the podcast by urging physicians who haven’t touched the technology to familiarize themselves with its capacities and limitations.
As a self-described “early adopter – when the new iPhone comes out, I’m the one who stands in line to get it,” Dr. Ahmed said he “truly believe[s AI] is going to be society changing. Anything like this that comes along, there’s a lot of trepidation that sort of bubbles up from our physician communities,” spanning a host of valid concerns, from impacts on patient relationships to job security.
Citing anecdotal fears within the radiology profession specifically about job loss tied to AI that have not borne out, Dr. Ahmed emphasizes the gravitas and clear-eyed perspective physician insight imparts to continuing medical education. “There’s a lot of wrong information, misinformation, and also just incomplete information. Having a physician-led CME sort of grounds the talk a little bit.”
And while “no one has a crystal ball,” part of the grounding effect physician input provides in associated CME helps cut through the noise. “It’s not just a bunch of hype, like ‘it’s going to be amazing,’” Dr. Ahmed said. “Where is this actually going to help patients and where can it harm patients and where should we be concerned? … These are the areas we need to talk about. That’s where the physician-led CME is very valuable.”
In a group chat with Dallas and Houston physicians Dr. Ahmed belongs to, AI dominates the conversation.
“That is the No. 1 topic – has anyone tried this technology? Has anyone tried this [other] technology?” he said, identifying administrative tasks as the most topical, lowest-hanging fruit. “Getting more insight and awareness and making more CMEs on those topics could be really helpful in practicing the whole breadth of what it means to practice medicine now.”
An affinity and lived experience
The everyday exigencies of the practice of medicine and their impact on physician wellness inform a CME Bethany Powell, MD, co-developed and co-presented with Cristel Escalona, MD. “Non-Negotiable Pillars of Wellness,” an on-demand webinar in TMA’s Education Center, proffers diet, sleep, activity, and mental health support, including TMA-partnered Anticipate Joy, as avenues of self-care for physicians.
“A lot of [why physicians put together CME] is we have already an affinity to a topic,” spurring development of a CME module, said Dr. Powell, a Galveston family physician.
The doctors’ webinar acknowledges the day-to-day realities of a busy physician’s life that can make perfect adherence to the best-laid plans in any of those categories unattainable.
“When we’re developing [CME] for our colleagues or really anyone, we’re on the ground. We’re the ones that are there experiencing it, and we’re facing the same challenges. And so it speaks to the experience and what we’re all going through. I think it’s easier then to relate.”
For example, pristine sleep hygiene is challenging to maintain for a medical resident or any physician who is on call, which “Non-Negotiable Pillars of Wellness” acknowledges.
“Unless you’re the one on call and you’re having to juggle that, how else would you know unless you’ve walked in that?” said Dr. Powell, who sits on TMA’s Committee on Physician Health and Wellness.
In the talk, Dr. Powell shares the HALT (Hungry, Angry, Lonely, and Tired) technique and recalls her own journey giving up cigarettes decades ago to move forward from her residency to becoming an employed family physician. The technique asks people to check in with themselves when they feel irritable or off-kilter by assessing if they are hungry, angry, lonely, or tired to support good decision-making.
“When we are the ones who have experienced it and understand how challenging it is, when someone hears what we have to say, they recognize we’ve been there. And it’s not just some perceived experience; it’s actually a lived experience,” Dr. Powell said.
“You can pick that up from a CME, I think, or you can pick that up from the presenter and from the information that is highlighted as important. I think you can just feel it.”