If you missed previous segments of the CMEslinger saga, you can read them here:

• Part 1
• Part 2
• Part 3
• Part 4

And now, our latest segment:

Part 5 (Scott)

As Sierra ambled down the spiral staircase that led into the front lobby, the CMEslinger was struck by how much his daughter had changed since the last time he saw her. It had been, what, 9 months since he drove the three hours to Sierra’s trendy loft apartment and took her out for her birthday?

“Geez,” the CMEslinger mumbled to himself. “Guess I should return that ‘World’s No. 1 Dad’ coffee mug.”

Sierra looked, well, different. Her hairstyle, her clothes, her general demeanor – she just didn’t look like the confident, sometimes cocky, young woman the CMEslinger was used to seeing. She looked tired and scared. It was enough to make the CMEslinger want to throw his arms around her like he used to do whenever Sierra came to visit him in the TAXIE offices as a little girl.

“Hi dad,” Sierra said as she hugged the CMEslinger, seemingly more out of obligation that familial affection. “Marge told me you’d probably show up sooner or later. You and your friend. Come on, let’s get on with it.”

A no-nonsense kind of gal. At least something about Sierra was the same.

Sierra signed in her visitors, escorted them to the corporate elevators located down the hall, and hit the button for the 24^th floor. When the elevator doors swung open, the CMEslinger and the man in black stepped out and stared in awe. They could see the entire city before them through the bank of glass windows. It was the kind of view most people would pay millions for. But then again, Tower Pharmaceuticals had many, many millions to spend on that sort of thing.

Sierra glared at the duo.

“If you want to play tourist, I can come back in an hour.”

“No, no, of course not,” the CMEslinger stuttered. “Lead the way, darling.”

“Don’t darling me, dad,” Sierra said. “I’m not your little girl, anymore.”

“So much for the teary family reunion,” the man in black muttered out of the side of his mouth.

“I’m no ingenue,” Sierra said, overhearing the man in black’s utterances. “But you already knew that. Come on already.”

Sierra led the trio down the hall to her office, adorned with a brass nameplate and a caricature of Velma, the sassy detective from the Scooby Doo cartoons. As her door swung open, Marge glared at the CMEslinger and the man in black.

“It took you long enough to get here,” Marge said. “I’m almost done my part. Now it’s up to you…and her…to save the day.”

“Almost done what? And what are we saving?” the CMEslinger said.

“You mean, you…they…” Marge said, looking inquisitively up at Sierra.

“No, I never called them,” Sierra said. “I didn’t want to… well, I was embarrassed.”

“Well then, I guess you better start from the beginning,” Marge said. “You boys better sit down. Storytelling time will let me finish up my part of this job before I hightail it out of here. I assume the folks back at TAXIE are pretty nervous right about now.”

It was all a bit much for the CMEslinger and the man in black to take in. But before they could start asking questions, Sierra had taken their arms in hers and walked them over to the cushioned sofa in the corner of her office. She pulled up her desk chair beside them and started to speak.

“Four years ago, the annual ACCME Data Report came out and, as usual, I immediately put my work aside to check out the financial state of our industry. And as usual, it was depressing. Registration fees were down 5%. Advertising and exhibits down 7%. Commercial support down 10%. It was the same story year after year. Depressing depressing depressing.

“So I went home, heated up a mug of tea and sat down in front of the television to watch the 76ers game with my journal in front of me. And that’s when it happened. Another ad for Linvolus, Tower Pharma’s ‘diabetes wonder drug.’ A midcourt Tower Pharma logo right in front of the 76ers bench. Tower Pharma patches on the uniforms of the 76ers players.

“I did some digging online and found that Tower Pharma had spent $510 million on direct-to-consumer advertisements for Linvolus alone in the United States that year. I’m sure those corporate sponsorships were in the hundreds of millions as well. Guess what they spent, at least according to their corporate transparency report, on CME programming for diabetes? $4 million. Total.

“I was tired of being underappreciated, but I was on the provider side of our world, so what could I do? So I made it my goal to come here and make things right. Six months later, I was hired.”

“But why didn’t you tell me, or anyone, all of this when you left TAXIE?” asked the CMEslinger.

“Remember what you told me when I came home with a black eye and a bloody lip after getting into a fight with Jessica Bronwell, that mean girl down the street, when I was 9 years old?” Sierra asked.

“Yeah, she was 3 years older than you and was twice your size,” the CMEslinger replied. “What did you expect?”

“But did you remember exactly what you said to me?” Sierra said.

“Sure, I told you the same thing my old man told me when I was a kid,” the CMEslinger said. “’Never get into a fight you have no chance of winning.’”

“Exactly,” Sierra replied. “I knew that one person fighting for dollars within Big Pharma seemed like the same situation, and I knew everyone was going to tell me that I was wasting my time, but it just felt like something I had to do. Not just for me, but for everyone who worked in CME for so long. For Marge. For the man in black. For you.”

“I see,” the CMEslinger said.

Tears started forming in the corner of Sierra’s eyes.

“And the worst part of it all is that you were right. I’ve been here for three years now and keep banging my head into the same wall over and over. I’ve worked hour after hour crunching data from providers, showing hard facts on the beneficial effect our limited budget is having on the healthcare team and the care of diabetes patients, arguing to my bosses that they don’t need another 30-second Linvolus commercial during the NBA playoffs. But I’m getting nowhere.

“Two weeks ago, I finally had enough. There was an advertising team outside my office filming a new commercial that is going to air during the Super Bowl – I read that we’re paying $10 million for 30 seconds of airtime. That is nearly three times my annual budget gone – poof – in about the time it takes you to drink one of your pickletinis.

“So I did something really, really stupid one morning. I called up one of my buddies in IT and had him override the budgetary limits of my grant approvals. I had been saving 15 of the best proposals that were submitted to me last year in the hopes I would miraculously convince my bosses to push more funding my way. In one fell swoop, I approved them all. $10 million worth of grants. Exactly what we’re paying for the Super Bowl commercial.”

“And that’s when you called in your emergency team,” the CMEslinger said. “Marge.”

“I didn’t know what else to do,” Sierra said. “I knew that as soon as anyone with their hands on the department budget found out about what I did, the best thing that could happen was that I would be fired. I ducked every email and phone call from the supporters whose proposals I had funded and avoided countersigning any LOAs. But that wasn’t going to last long.”

Now it was the man in black’s turn to chime in.

“And so the two of you have been doing what, exactly?” he asked. “You realize that you pulled Marge away from TAXIE during their most crucial time of the year? They may lose their accreditation.”

“I know,” Sierra said. “And I feel awful about that. But we’re not stupid. Marge told me exactly how long she would be able to spend helping me here. We’ve been squeezing every ounce of energy into our value proposition to try to convince our executives once and for all that we’re worth investing in.”

“I’ll be leaving in a few minutes,” Marge interjected. “TAXIE will be fine. I have all of my files in pristine condition. I knew you would eventually figure out I was here and that you would come to save the day. Which you’ll be doing very soon.”

“Save the day? How exactly am I going to save the day?” asked the CMEslinger incredulously. “Besides you, I don’t know anyone else who works here. I don’t have any influence on any decisions this company makes.”

“You’re right, dad,” Sierra said. “You won’t be saving the day, at least not this time.”

Sierra locked eyes with Marge before swiveling to point her finger at the man sitting astride the CMEslinger, at the man in black.

“He will.”

Punxsutawney Phil saw his shadow – six more weeks of winter. Sigh.

Usually, we don’t care so much about what the seer of seers, sage of sages, prognosticator of prognosticators and weather prophet extraordinaire has to say about the seasons, but since these last few weeks have been particularly harsh for most of the country, we’re a little depressed now that spring seems further away.

You know what else has got us depressed? Our Ask Us Anything mailbag. It’s about to be empty, which should never happen. Surely you have professional and/or personal problems that you need us to weigh in on. Can you save your parking spot that you spent an hour digging out after the recent snowstorm with a traffic cone? What’s the best thing to do on a first date? How many licks does it take to get the center of a Tootsie Roll pop?

Our advice might not always be good, but it will be thoughtful and it is free. So please, submit your Ask Us Anything questions here so that we can at least have a ray of sunshine brightening our psychological skies.

And now, here is what we have to offer this month…

Dear Derek and Scott,

After reaching out to several supporters, I’ve noticed that some are happy to meet at the Alliance meeting while others are very clear that they don’t take meetings there. What drives supporters’ decisions to meet at the Alliance meeting, and why do those approaches differ?

Annoyingly,

Denied but Not Defeated

DEREK: This is a timely question considering the Alliance meeting is coming up in less than 2 weeks and I was just discussing this very issue with a couple colleagues last week. As a supporter, I’m happy to provide my thoughts on this situation and will take a crack at explaining the opposing view, too. As usual, I am compelled to provide a disclaimer that these are my own opinions, do not reflect those of my employer, blah, blah, blah.

My personal view of meeting with providers at the Alliance meeting and other conferences is that I am willing to meet and will try to agree to as many meetings as I can without driving myself nuts–accepting them on a first come, first served basis. I consider these kinds of meetings to be part of my job responsibilities and my role as a supporter. In general, I don’t have a lot of in-person external meetings throughout the year, so I’m willing to agree to more when attending conferences. Admittedly, part of my motivation stems from the years I spent working for CME providers in the first half of my career, so I guess I feel like I have a decent understanding of the value of these meetings from that side.

But let’s be honest, the true reason for this question is to ascertain why supporters don’t agree to meetings. I’ll offer three brief explanations based on conversations I have had with other supporters and my own experience.

The first reason is one of fairness and equal opportunity. If provider/supporter meetings are of value to the provider, and it is impossible to meet with every provider, then those who do meet with supporters are at an unfair advantage. If supporters can’t meet with every provider, then it is better for them to meet with no providers than some providers.

The second reason is to negate any appearances of bias and impropriety. We all know the work of CME is heavily regulated on both the provider and supporter sides of the equation. Some individuals and organizations feel the best way (or easiest way) to reduce the odds of getting caught up in any potential conflicts of interest is to avoid provider/supporter meetings entirely.

[Quick shoutout to Pam Wagner, who discussed both of the issues above in a recent LinkedIn post.]

The third reason, and the reason I concur with more than the first two, is simply one of time. These meetings take a lot of time and can make it difficult to enjoy the full conference experience. I’ll use myself as an example. For this year’s Alliance meeting, I received 20+ requests for meetings and have 14 scheduled, not counting evening meals. Along with those meetings I also have a session to moderate, try to catch up with friends I only see at conferences, and hopefully attend a few sessions as well. I have no idea how this compares with other supporters, but I assume they receive a similar number of requests and some likely even more. I share this not to brag or anything like that–it’s just how it is. This is probably oversharing, but for me, face-to-face meetings sap my energy. I’ll be exhausted by the end of the conference and start to lose my voice partway through from all the talking. When I decline a meeting request, it’s because I’ve reached the saturation point in my schedule. It’s not you, it’s me.

SCOTT: I don’t have a lot more to add here as I have never been on the supporter side, though I can certainly understand the concept of “meeting fatigue” that Derek cites. While I have never been a big fan of provider capabilities presentations, I do understand the value of personal relationships in our field and have always appreciated the willingness of some supporters to provide me with a glimpse of how their specific organization is structured and the way it which their team determines which education they do/don’t support. In many ways, I prefer this to happen during casual interactions rather than forced discussions during scheduled meetings, but I understand this occurs by happenstance and simply luck in running into someone you were hoping to meet.

Dear Derek and Scott,

I am thinking about submitting an abstract for presentation at CMEpalooza Spring along with one of my colleagues, but I’m not sure if our idea is any good or if we even have a chance at being accepted. Plus, neither of us has really presented to an audience like this before, so we’re kind of nervous that we’re going to make fools of ourselves.

Do you have any advice so that can make me feel better?

Sheepishly,

Nervous Nelly

SCOTT: You’ve come to the right place, Nelly, because Derek and I have years upon years of experience in making fools of ourselves. In fact, that would be a great name for our band if either of us was musically inclined (sadly, my instrumental career ended back in 5th grade when I put down the viola for good).

We often hear from people who kinda sorta think they have a good idea for a CMEpalooza Spring abstract but either they are too shy, lack confidence, or just get too preoccupied with other things to remember to submit it for consideration.

(Quick aside: This is a good opportunity, of course, for us to remind everyone that there are less than 3 weeks until abstracts for our Spring event are due. You can get all of the details on the submission process by clicking here).

We always consider CMEpalooza to be a low pressure kind of presentation atmosphere for a number of reasons:

1. You are not physically “seeing” your audience so there is no intimidation into looking at a sea of faces staring at yours. With a virtual event like ours, there could be 1 people watching or 1,000 (in reality, it’s somewhere in the middle). It really doesn’t make any visible difference to the presenter.
2. We encourage fun and creative approaches to education. You won’t have the pressure to come up with a long slide deck, unless you really want to. You won’t have the pressure to develop pages and pages of notes to keep you on track, unless you really want to. While we don’t encourage “winging it” without some sort of plan, we also don’t require any specific plan of attack. You can figure out your own preparation preferences.
3. We love seeing new faces present. While I admittedly will attend some sessions presented by longtime friends and colleagues who I admire at live events, one of the benefits of CMEpalooza is that you get a time slot with no competing session AND your session can be viewed as soon as it’s completed in our online Archives. Which are there forever and forever. All for free.
4. I’ll let you in on a little secret – we don’t get hundreds of great submissions to consider every year. We never know exactly how many submissions will come in, but your odds of being accepting for a presentation slot are significantly better than last week’s Powerball, for which your bought 10 tickets.

Derek, you want to add anything? I know your top 10 lists, so I left you a few to fill in. You are welcome.

DEREK: How very generous of you. No, I think you have covered the main points pretty well. I do want to reiterate that CMEpalooza is about as low stress an environment for presenting as you can find while still reaching a decent sized audience. And if it helps, we’re happy to lie to you about how many people you are actually presenting to, since you won’t be able to tell (“What’s that Nervous Nelly? How many people are watching your session? Oh, it’s only a handful, and one of them is my mom. Nothing to worry about. No truth at all to the rumor that we had 250 people watching the previous session. OK, maybe there’s a little truth to that rumor, but only a little.”)

If you missed previous segments of the CMEslinger saga, you can read them here:

• Part 1
• Part 2
• Part 3

And now, our latest segment:

Part 4 (Derek)

The CMEslinger grabbed his leather duster and stroked the shearling collar for a moment before shrugging it on. The coat had been a 50^th birthday present from his daughter, Sierra, a few years back and was one of his few treasured possessions. The CMEslinger is not a man who surprises easily, but the quality of his daughter’s gift, not to mention the cost, had caught him off guard at the time. It shouldn’t have.

Sierra had been a precocious child, talking at 10 months, reading at 4 years old, reciting Gertrude Stein by memory at the third grade talent show (“Rose is a rose is a rose is a rose”). She tested out of fifth grade entirely and graduated from high school the same year she turned sweet sixteen. Scholarship offers came in from Harvard, Yale, and Stanford, but Sierra shocked everyone by staying local and attending Cuthbert University—a fine school, but one lovingly known as “Safety U” because no one ever listed it as their first choice. But Sierra had plans of her own, and an Ivy League education was not part of them.

There is a common saying in CME circles that “no one gets into CME on purpose.” Phinneas, of course, had his own version of that, snorting “No one gets into CME; CME gets into you!” at the CMEslinger and the man in black more times than they cared to remember. Sierra would prove the exception to that rule with a singular focus on a career in CME that could only come from an offspring of the CMEslinger. As a toddler, she would tag along with him to the TAXIE office, and even when he moved on to form his own company, Sierra remained a TAXIE loyalist and became a key member of Marge’s program management team by her senior year in high school. It didn’t hurt that Marge was also her godmother, but no one ever questioned Sierra’s capabilities. She would have skipped college entirely and gone full-time at TAXIE, except the CMEslinger put his ostrich skin booted foot down and insisted she get her degree (though it was actually the heartfelt talk between Marge and a tearstained Sierra that convinced her to accept a spot at Cuthbert and delay her burgeoning CME career by a few more years.)

At her graduation ceremony at Cuthbert, Sierra walked across the stage, grabbed her diploma, and hurried directly over to her new office at TAXIE, something given only to those with a promotion to Senior Program Manager. Over a period of 5 years, she rose to Program Director and then Vice President of Educational Strategy, the youngest employee to which TAXIE had ever bestowed a VP title. Her father’s advice helped, but it was Marge and her tough love approach that Sierra credited most for guiding her in her career. She was 25 years old, a VP at one of the largest medical education companies in the world, and the apple of the CMEslinger’s eye.

And then she went over to the dark side.

It is an inside joke to those who exist in the CME provider world, referring to the industry section of CME as “the dark side.” Still, it came as quite a shock to everyone, Marge included, when Sierra announced she was leaving TAXIE for a Grant Director position at Tower Pharmaceuticals. And yes, the CMEslinger had to admit, it stung him more than a satchel full of hornets that his little girl was leaving the provider side for a job on the dark side. He never did get a full explanation from her about why she was leaving. “I’m sorry, Dad. It’s just something I need to do,” was the most he ever got out of her.

She never offered an explanation to Marge, either, and Marge never asked for one. On Sierra’s last day in the TAXIE office, as she was making her final walk down the hallway towards the elevator, Marge called her into her office, where she sat speedily clacking away at her computer keyboard. Tilting her head down slightly and looking at Sierra over the top of her halfmoon readers, Marge imparted a final bit of advice.

“You call me when you run into trouble.”

“’When”? Not ‘if’?”

“Yes, ‘when’.”

“OK, Marge. I will. Thanks.”

Marge nodded and went back to typing. She never looked back as Sierra walked away.

All this the CMEslinger relayed to the man in black as they Ubered over to Tower Pharmaceuticals HQ.

“Yes, I know all this already, you chucklehead,” the man in black growled. “You forced me to listen to all your stories when Marge locked us in that hotel room in Vegas.”

“Ah, right, right,” the CMEslinger intoned absently.

The Uber glided up to the massive black edifice of Tower world headquarters, and the two unlikely partners jumped out and hurried into the front lobby. Neither man had been in the building previously, and it took them a moment to spot the intercom system for contacting occupants. Quickly scanning the directory, the CMEslinger punched in the numbers for Sierra’s office. She picked up on the first ring.

“Yes?”

“Sierra? It’s Dad. I’m downstairs.”

“Oh.”

An awkward silence of several seconds followed, interrupted only by the low frequency hum of the intercom.

“Sierra? You still there?” the CMEslinger asked hesitantly

“I’ll be right down,” his daughter said sharply and disconnected the line.