What makes a good CME topic? For Samuel Mathis, MD, it’s easy: Start with what people are talking about.
In 2024, Dr. Mathis created a CME course to improve physicians’ knowledge about interactions between common drugs and supplements. A better grasp of the complications, he reasoned, could lead to more informed discussions with patients.
“Often times for me, my presentations stem from the questions I receive, from either the patients or other clinicians, specifically in the area of expertise that I have,” the Galveston family medicine specialist said. “If I’m getting a question fairly regularly, then numerous people have that question.”
Trending topics are always in vogue when the Texas Medical Association develops new CME offerings, but the path from a physician’s idea to a course featured at TMA’s annual conference, TexMed, or in the TMA Education Center is more extensive than it might appear.
For experienced physicians, tallying CME credits is nothing new. The Texas Medical Board (TMB) generally requires physicians to complete 48 hours of CME every 24 months to maintain their license, with at least half in formal Category 1 or 1A courses. As part of the formal 24 credits, physicians must complete two hours of ethics and professional responsibility education plus certain other requirements. There are also other state-mandated requirements that may apply.
There are more than 100 courses in the Education Center designed to help satisfy the state’s mandates. TMA offers members a range of subjects for free, thanks to funding from the TMA Insurance Trust (TMAIT). Physicians may also access CME through their employers or other third-party providers.
But can run-of-the-mill courses give physicians information they can actually use in their next patient appointment? If the goal is continued education, then every physician should get something – a kernel of wisdom, a best practice, anything practical or useful – from every hour of CME.
According to Triwanna Fisher-Wikoff, MD, chair of the TMA Committee on Continuing Education, TMA’s free-to-member offerings aren’t just adequate – they’re exceptional.
“[The offerings] tend to follow the best and evidence-based guidelines, whether it’s clinical, administrative, or business-like,” the Fort Worth family physician said. “Everything is reviewed to make sure it falls within the standards of competence, performance, and knowledge.”
For Dr. Fisher-Wikoff, it’s critical that all physicians who use the CME offerings build competency, improve practice performance, and translate what they’ve learned into better patient care.
TMA has provided free CME courses to members since February 2018. In 2022, TMAIT began providing annual gifts to the Education Center to offset ongoing costs. What started as a modest gift just a few years ago has grown to $700,000 annually, according to TMAIT Executive Director Guy Patterson.
Mr. Patterson says the trust manages claims like any insurer. However, the organization has a larger obligation to help physicians rather than a traditional company beholden to shareholders.
“We operate solely for the benefit of the Texas Medical Association physicians,” Mr. Patterson said. “Any surplus funds that we don’t use to pay claims for TMA members, we put back into what we call Insurance For Good.”
Powerful ideas to PowerPoint
Physicians may have the world’s greatest idea trapped in their heads. Getting it onto paper, translating it to a slide deck, and presenting it to a room full of colleagues is another matter.
For those who want to create stand-alone CME courses, the process starts by getting in contact with TMA’s Cheryl Krhovjak, director of the Education Center.
“When I get requests like that, where physicians have developed something they think is beneficial, depending on the content, I will ask the appropriate council or committee for discussion,” Ms. Krhovjak said.
TMA staff, along with members of the various councils and committees, will vet the information and the presenter. That would include seeing if TMB has any actions against the presenter or if there are generally any red flags discovered online.
TMA’s Committee on Physician Health and Wellness plays a significant role in helping physicians develop and present in-person CME courses at TMA’s annual TexMed convention, according to former chair Toi Blakley Harris, MD, who now serves as a consultant.
To identify topics, committee members collect survey data about what members want to learn, consult with physician leaders, and review de-identified aggregate data to spot broader health issues worth addressing.
Within the committee, an ad hoc steering committee formulates CME topics and works with physicians to develop their content, with TMA staff walking with committee members throughout the process.
The steering committee then presents ideas to the full committee, which forwards them to the final group – TMA’s Committee on TexMed Education. Those members extend formal invitations to physicians to present their CME at TexMed.
“It’s really a process that involves multiple inputs where the aim and mindset is to see if there are any gaps or emerging needs that aren’t really covered through the TMA’s education platform,” Dr. Harris said.
Sejal Mehta, MD, gave a well-received presentation at this year’s TexMed in Corpus Christi on practical, everyday uses for artificial intelligence (AI) in medicine. In her view, it’s no longer a question whether physicians should be using AI – the question is which tools are safe, how they fit into one’s practice, and how physicians should implement them responsibly when regulatory changes may create liability risks.
“Years ago, before COVID, we used to have at least 500 people in the hall attending CME at TexMed. Now, it’s maybe down to 50 or 100,” the Plano psychiatrist said. “Post-COVID is difficult because everyone is online. Online CMEs are easy to get, which is fine, but in-person CMEs have value. We should definitely encourage more members to attend CMEs in person, virtually, or whichever way.”
Keep it simple
AI is a red-hot topic chugging throughout medicine and society, and that train isn’t slowing down anytime soon. That’s why Joseph Schneider, MD, teamed up with Jawahar Jagarapu, MD, at TexMed for another AI-focused CME session, this one on the technology’s practical uses in clinic operations.
“We sort of thought about our topic areas and said, ‘What should we tell folks about it so they have some good understanding of it?’” said Dr. Schneider, a former chair of TMA’s Council on Practice Management. The course is available in TMA’s Education Center.
Physicians who present CME are essentially sharing first-hand knowledge and experience with peers, something that carries its own value. As for constructing your presentation, Dr. Schneider has some simple guidelines.
“Know your audience,” the Dallas pediatrician said. “I think my dad taught me that, because every time he made a presentation, he thought about, ‘Who are you giving this to?’ And know your subject. You have to know the ins and outs of what you’re talking about.”
Physicians who spoke with Texas Medicine about CME creation were unanimous in support of Dr. Schneider’s final point: Keep it simple, because complex slides or complex content makes it difficult to follow.
Dr. Schneider recalled a CME presentation from years ago on electronic health records keeping everyone’s attention because of the presenter’s on-screen graphic. “He put up a big yield sign and stuck one word on it: ‘Fraudelicious.’ That was it, whereas most of us mere mortals would have four or five PowerPoint slides.”
The point – the temptation to upcode in early-stage electronic health records – was clear.
“Every time I do a presentation of some sort, I am teaching myself as well,” Dr. Schneider said. “When it came time to do that presentation in April, there were things I didn’t know and had to learn more about to do the presentation. Doing these is a way of keeping fresh.”
Topics that resonate
Many of the CME offerings in TMA’s Education Center feature broad-based topics, since some physicians prefer to look elsewhere for course materials geared to their specialty. AI, business, and burnout-related topics have done well, according to TMA staff.
At TexMed in April, Joy Lo Chen, MD, led a physician-focused session examining how disruptive personality traits can undermine teamwork, communication, leadership, and ultimately patient safety. Drawing on real-world examples, she discussed ways physicians and health care leaders can recognize these behaviors and foster healthier workplace cultures.
“Topics like leadership, teamwork, communication, and organizational psychology are relevant whether you’re an anesthesiologist, surgeon, internist or pediatrician,” Dr. Chen said. “They’re challenges that every physician encounters, regardless of specialty.”
Her presentation followed a well-attended TexMed session the previous year on imposter syndrome – the tendency to doubt one’s abilities despite clear evidence of competence. The discussion that followed highlighted how common the experience is across all stages of a medical career.
“Medicine has traditionally emphasized clinical knowledge and technical expertise,” the Dallas critical care anesthesiologist said. “But many of the biggest challenges we face involve the human side of medicine – how we lead, work together, navigate difficult personalities, and understand the principles of organizational psychology that influence our teams.
“TMA has created a valuable forum for conversations about these topics because they ultimately help physicians become more effective leaders, teammates, and clinicians while improving patient care,” Dr. Chen said.
According to Dr. Harris, “There are opportunities for physicians to get more involved.”
At the local level, Dr. Harris suggested, physicians can contact their county medical society.
“The medical societies contribute significantly to the CME tracks we have at TexMed,” she said. Physicians can also reach out to members of the Committee on Physician Health and Wellness for information on how to participate more actively in CME programming.