Over the course of the last 12 months, I have read a variety of books and watched several documentaries about the career arcs of successful singers/bands from the 1970s-80s. REM, Billy Joel, Chicago, Carly Simon, Red Hot Chili Peppers, Linda Ronstandt, and others. While every one of these has their own story and unique twists, the career arcs are remarkably similar and look something like this.

Basically, the singer or band plays around with their sound for a few years in their teens and/or early 20s, people float in and out of the initial lineup, and some lone wolf talent scout/producer “discovers” them and signs them to a horribly one-sided contract that the singer/band never reads because they just want “to focus on the music.”

The singer/band slowly starts building a local/regional following before — BOOM! — they take off like a rocket. Top 10 hits. Gold records. Sold out arenas. The creative juices are flowing, and the group can do no wrong. The bandmates are all best friends and living it up.

Then comes the inevitable plateau. Things are still good. There are a few more hits and many records are still being sold, but cracks begin forming. Drug/alcohol use and late-night partying becomes more important that the music, in-fighting starts to occur, and everyone finally realizes that, “Hey, why aren’t we being paid very much money despite our success? Where is that initial contract anyway?” Fingers begin being pointed every which way.

This is when the decline begins. The group has been touring nonstop for years just to make some money after lawyers free them from their initial onerous contracts. Creativity and passion plummet. It’s no longer “all about the music.” The next record bombs, the record label threatens to drop them, and the band fractures. Maybe the lead singer decides to go out on his/her own, maybe the drummer who has been consistently late for rehearsals is replaced, maybe someone goes into drug/alcohol rehab (OK, pretty much always someone goes into drug/alcohol rehab).

Once things settle down, the singer/band may have another blip of success, but more likely settle into their role as a “nostalgia” band. They will often still record new material, but it’s rarely inspired or successful. The best of them will still play to packed arenas as they embrace sobriety and give their now-middle aged, moneyed audience a reminder of their younger, carefree days (Good God, Willie Nelson is still touring at 93!).

After watching the most recent of these documentaries, I got to thinking how CMEpalooza aligns to this sort of career arc. There are a few similarities. Certainly, Derek started CMEpalooza and I joined shortly thereafter with hopes for success but just a vague blueprint of what that might look like. As we gained traction, both with sponsors and our audience of CME professionals, we grew in popularity. You might say our “big hit,” ironically enough, happened during COVID, when the whole world was virtual and CMEpalooza was one of the few established events that continued unencumbered. The audience for our events basically doubled overnight.

In those days, we had a lot of creative ideas for sessions, and our blog stayed busy as we regularly emailed each other with “Hey, I’ve got another idea for a blog post this week. Wait, so do you? Great!”  We were rolling along.

Assuming we follow the trajectory of the musical superstars—presumably skipping over the stint in alcohol/drug rehab—this is about the time we should hit our plateau and, quite frankly, that is a scary proposition. No one wants to be on the decline in anything that they do, and dammit, we’re going to fight like hell to stay on top.

We still have spurts of creativity (admit it, you love the CMEslinger), although it can be harder to tap into at times (note from Derek: a lot harder). Our “Hey, I’ve got another idea for a blog post this week!” exchanges don’t come quite as frequently as they used to. Personally, what gets me excited most often these days is exchanging ideas with our community and getting them to challenge me to come up with creative solutions. We have a few sessions this Spring that are pushing the envelope and usual boundaries of education, which is always fun and professionally enriching.

Will we still be doing CMEpalooza on our 93rd birthdays? Probably! (OK, definitely not). But I also hope that we’re not going to be that nostalgia band who people watch simply for the memories of those good old days any time soon. I think we still have a few years of life in us.

Imagine it’s late 1991. You’re sitting in the driver’s seat of your used Mazda RX-7 in the 7-Eleven parking lot, sucking on the straw of your Big Gulp filled with ice cold Orange Crush, which you bought to calm yourself down after you accidentally dropped your Queensrÿche Empire cassette on the ground and clumsily trod over it with your black British Knights high tops. Disaster!

Wiping an orange drop off your Bugle Boy jeans and adjusting the class ring you just picked up from Jostens, you snap on the car radio and rest your mulleted head back against the headrest as the opening strains of Temple of the Dog’s Hunger Strike begins to play.

Oh great, you mumble to yourself, just what we need, another pseudo-grunge Pearl Jam knockoff.

Then the lead singer makes his first appearance.

I don’t mind stealin’ bread..

Hold on a minute, you think. That sounds like Eddie Vedder.

From the mouths of decadents…

You straighten up in your seat a little. That is Eddie Vedder. What’s going on here? Is there a new Pearl Jam song out? And old unreleased song? Whatever it is, it’s pretty good. Your day just got a little bit better.

You keep listening, nodding along, making a note to next time ask Sheila at the Hair Cuttery to trim the top a little shorter so your gelled-up spikes don’t brush the roof of the RX-7. So annoying!

Then the chorus kicks in.

I’m going hungryyyyyyyyyyyyyyyyyyyyyyy…(going hungryyyyy-AYYYYYY)

Wait wait wait wait wait wait wait wait wait wait wait wait. No, that can’t be right. That sounds like Chris Cornell doing the echo, but that’s impossible.

You reach out and turn up the volume.

I’m going hungryyyyyyyyyyyyyyyyyyyyyyy…(going hungryyyyy-AYYYYYY)

I’m going hungryyyyyyyyyyyyyyyyyyyyyyy…(going hungryyyyy-AYYYYYYAYYAYY)

I’m going hungryyyyyyyyyyyyyyyyyyyyyyy…(going hungryyyyy-AYYYYYYYYYYYYYYYYYYYYYY)

That is definitely Chris Cornell. You would recognize his voice anywhere, because if Pearl Jam is your favorite band, then Soundgarden is next on the list.

You keep listening, still a bit stunned, to Eddie Vedder and Chris Cornell trading lead vocals for the rest of the song. It’s hard for you to believe that, unexpectedly, some of your favorite people are together in the same place.

Last week, I had the pleasure of joining two of my favorite colleagues, Karen Roy and Greselda Butler, for a presentation on Bridging the Gap: What Medical Affairs Can Learn from CME to Elevate External Education at the Medical Affairs Professional Society (MAPS) Annual Americas Meeting. It was my first time attending MAPS and, if I’m doing my math correctly, my first time presenting at a non-CME/CE conference. I’m pretty sure that’s accurate. At the very least, it’s been quite a while since I’ve done a presentation that was not primarily focused on a CME/CE audience.

I’ve been attending the Alliance conference for 25 years, and when I go, I see more familiar faces than unfamiliar faces. It’s basically a reunion of old friends and colleagues. Since this was my first time attending MAPS, I saw far fewer familiar faces…or so I expected.

One of the cool things for me at the conference was that I kept running into pockets of IME friends at different times and places: strolling down the conference hall; presenting at a workshop; grabbing lunch from the table stacked with extremely mediocre sandwiches; at the hotel lobby bar after the last session. Hey, is that Wendy at the podium? I think that’s John holding a glass of white wine. Shoot, Mike just took the last turkey wrap. Familiar faces in unexpected places. It was fun to unexpectedly find some of my favorite people together in the same place.

A unique trait of the CME/CE community is that it is just that—a community. We do the same work. We work in the same places. We go to the same meetings. We know the same people. We have our ups and downs. People come and people go. But we are a community and that’s something I truly appreciate.

This is a continuation of our special AUA: IME Supporter Edition from earlier this week. Click here to view Part 1.

As a reminder, if you have an issue (professional or personal) you would like help with, click here to submit your question(s). We like offering advice and people seem to enjoy hearing our opinions (we won’t comment as to whether our advice is any good).

Now, on to the questions!

Q: In terms of the number of participants, are you seeking the highest number of participants or evidence that it is the right target audience?

Each organization views this differently; however, I would venture that for the majority of us, we are seeking evidence that the right audience participated in the education. High numbers can catch one’s attention, but our medical teams are getting more savvy. Depending on the disease state, a high number of promised learners will instantly draw skepticism and dilute the value of what we are trying to convey. When medical starts asking questions about who participated in the program, and the only information we can share is a large number and not evidence that it was our target audience, we’ve lost their interest and a chance for them trusting the value of the data we’re sharing.

Q: Trying to determine what each grantor requests for outcomes/impact is challenging. Whatever happened to the Outcomes Standardization Project? 

The OSP has been effective in establishing consistent definitions for terms commonly used across our industry. From what I have observed, many providers have adopted these OSP definitions, and when reviewing grant submissions, I do appreciate when groups apply them. If a provider chooses not to adopt OSP definitions, I would expect them to clearly explain how they are defining clinicians and the phases of engagement within their program.

All that said, expecting full alignment in outcomes reporting across companies is likely unrealistic (note from Derek: Yup.) Supporters have emphasized for several years that outcomes reports are critical for IME teams, but there is also increasing diversity in how programs are designed and evaluated. As technology continues to influence both society and education, CME programs have evolved and innovated in ways that generate more varied and unique datasets. Because of this, providers should move beyond focusing primarily on large participation numbers or basic pre- and post-test metrics. Instead, they should think more strategically about how to demonstrate program impact. The goal should be to communicate outcomes in a way that clearly conveys the value of the program to stakeholders who may not have a background in CME, while highlighting insights that will resonate with industry colleagues.

Q: Regarding multi-support, if it takes more than a year to get sufficient funding even to meet the contingency plan, do you prefer the provider keep seeking funding or would you like the funding returned?

Communication is vital in multifunder situations. First, I think the contingency plan should always include what can be accomplished with the amount of funding you requested from a single supporter. Then, once you receive approval of funding from a supporter, regular monthly updates on other support decisions are helpful. As the proposed start date approaches, there should be a discussion of whether the committed supporter wishes to move forward with just their support, wait for further decisions, or request that funding be returned. There are very few programs that I would be willing to wait a year for. And to my fellow supporter colleagues, I’d be interested in hearing why it is taking more than a year to make a decision.

Q: Where do the number of learners and the cost per learner rank on the list of things to look for when reviewing a proposal?

Cost per learner is not something I prioritize. What’s more important is the right audience and the audience generation methodology applied. If the provider is leveraging lists or distribution partners, I will dig into that. Can they deliver the right audience? What is the mix of disciplines I could expect (e.g. if I’m expecting physicians, is the program going to give me more nurses or pharmacists?). When I see large numbers, I question the authenticity of those numbers. I also try to dig into the demographics more. If the report has large numbers, and I am able to dig and drill down into my specific audience and learn that only 10% of the audience was my target learner, I will get frustrated. But the CME provider can redeem themselves if they perform a deeper analysis or segmentation of that small target audience. What is most important is seeing the data and impact on the audience that the supporter is interested in reaching.

Q: Is there ever any concern (Legal? Internal?) that RFPs might be seen as guiding content because of the detail provided?

This is absolutely something that our Ethics & Compliance and Legal departments are concerned about and why they are involved in the review of all RFPs before they can be posted. Some companies are more conservative than others, and like most things in IME, “guidance” and “influence” are open to interpretation. This is why providers may feel that some RFPs don’t really say anything about what the supporter wants to see. In these cases, the internal compliance folks likely have a wide interpretation of what constitutes influence on content, which ensures the information in RFPs remains at a very broad level.