The Big Interview You Might Have Missed

(DISCLAIMER: It goes without saying, but this is a satirical post. The interview didn’t really happen. Or did it….) 

On the heels of the publication of last week’s Q&A by MeetingsNet, Derek and I have become hot commodities on the interview circuit. The networks have been dealing with our agents, and we have the Times, Post, Tribune, Herald, and Daily News all waiting in the wings. I thought that Derek and I had made an agreement to hold off on any further interviews until things cooled down a bit, but he apparently doesn’t listen to me (shocking, I know). Consequently, when his favorite local cable access channel called to see if he’d sit down for a no-holds-barred interview with their ace reporter, Glen Wallace (yes, you know his more famous cousin, Chris) about the current state of CME, Derek couldn’t agree quickly enough.

For everyone who missed the interview – that would be all of you – here is the transcript in all its glory.

WALLACE: Thank you and welcome to “Chestnut Hill Corner.” Mr. Warnick, you’ve agreed to answer all manner of questions, no subject off-limits. Thank you for allowing such candor.

WARNICK: You are welcome, I guess. Wait, is my wife going to see this?

WALLACE: Let’s not worry about that right now.

Let’s start with the surge of virtual, live continuing education across the country in the last few months. You still talk about it as, quote, “a fad.” But I want to put up a chart that shows the number of learners at virtual, live events over the course of the last few months. As you can see, we hit a peak here in April of 36,000 healthcare provider learners a day. Then it went down and now since June, it has gone up more than double. One day this week, 75,000 learners in one day for live, virtual education. More than double.

WARNICK: Glen, that’s because we’re measuring attendance like no one else in the world. Our measurement skills are unbelievable. If we didn’t measure attendance like we are, you wouldn’t be able to show that chart. If we only counted half of the people who logged on as learners, those numbers would be down.

WALLACE: But this isn’t a fad, sir? This is a clear trend.

WARNICK: No, no. I say fad, it’s going to go away. We have some providers that are doing a lot of virtual, live education but we’re going to get that under control. And you know, it’s not just this country, it’s many countries. We don’t talk about that in CME circles. They don’t talk about all of the virtual, live education being delivered in Canada and Australia and in some parts of Europe. You take a look, why don’t they talk about Canada? They are doing a ton of virtual, live education. All I can say is thank God I told them to build proper firewalls, because if I didn’t, it’d be a huge problem from a compliance standpoint.

WALLACE: But sir, we are providing more virtual, live education than any country in the world. The number of CME certificates being generated is higher than Canada, it’s higher than Russia, and the European Medicine Agency said they will no longer accept credits obtained from virtual, live education developed in the United States.

WARNICK: Yeah, I think what we’ll do is turn that around and do the same thing. If you remember, Glen, I was the one who pushed very early to stop accepting CME credits for programs developed in Europe.

But when you talk about rate of noncompleters of new enduring activities, we have one of the lowest rates in the world. I think we have one of the lowest rates of noncompletion in the world.

WALLACE: That’s not true sir. We have a – we had 22% of people who didn’t finish the post-test on all cumulative virtual, live events one day last week. You can check it out.

WARNICK: (Turns to Fall intern TJ off screen) Can you get please get me the rate of noncompleters?

TJ is right here. I heard we have one of the lowest, maybe the lowest rate of noncompleters in the world. Number one rate of noncompleters. I hope you show the scenario because it shows what fake outcomes data is all about.

WALLACE: All right. It’s a little complicated, but bear with us. We went with numbers from the ACCME, which charted the rate of noncompleters for 20 countries with the most virtual, live education for healthcare professionals. The US ranked 7^th, better than the United Kingdom, but worse than Canada and Japan.

WARNICK: Whatever. Can we move on?

WALLACE: OK, sure. Physician education — numbers of certificates way up after completing a virtual, live educational event. Nursing education — the most credit hours in the last 4 months last week. Pharmacists completing their necessary hours of credit 6 months before they need to. A lot of people say this is because we don’t have a national plan to keep these numbers down. You talk about individual providers and accrediting organizations. We don’t have a national plan. Do you take responsibility for that?

WARNICK: I take responsibility for nothing. TJ, can I get some water or something? (TJ hands Derek a glass of water, wondering how she got suckered into this role).

Some providers have done well, some have done poorly. They’re supposed to be able to administer as many certificates as they need.

Now, we have somewhat of a surge in virtual, live education in certain medical specialties. In other areas, we really limiting it. But you don’t hear people complaining about connectivity issues. We have all the Zoom accounts we can use. We’re giving out usernames and passwords to other countries.

WALLACE: But, sir, the number of virtual, live events is up 37 percent in the last week.

WARNICK: Well, that’s good.

WALLACE: I understand. Certificates generated are up 194 percent. It isn’t just that the number of programs has gone up, it’s that the number of certificates is growing.

WARNICK: Many of those learners don’t even bother printing our their certificates. They click A, C, A, D, and we put it down as a qualified learner. Many of them – I guess it’s like 99.7 percent – aren’t even going to remember that they attended the virtual, live event.

Go out and look at the news – you’ll see the number of virtual, live events are up. Many of the noncompleters from those events shouldn’t even count. It’s like one presenter doing a 15-minute Zoom talk. The number of noncompleters are up because we have the best outcomes measurement processes in the world.

No country has ever done what we’ve done in terms of counting noncompleters. You look at other countries – they don’t even separate out completers from noncompleters. It’s a completer as soon as someone logs on. They don’t go around having massive areas of assessment and we do. And I’m glad we do, but it really skews the numbers.

WALLACE: Let me just, let me just ask the question, sir. Why on earth would your administration be involved in a campaign at this point to discredit Dr. Brian McGowan, who is one of the industry’s top experts in assessing completers vs. noncompleters?

WARNICK: Because we’re not. If one man from the CMEpalooza team doesn’t like him because he made a few mistakes — look, Dr. McGowan said, “Don’t measure all completions.” Dr. McGowan told me not to ban medical students from virtual, live events — it would be a big mistake. I did it over and above his recommendation. Dr. McGowan then said, “You prevented thousands of pieces of useless data about student learners” — more than that. He said, “You prevented tens of thousands of pieces of useless data.”

Dr. McGowan’s made some mistakes. But I have a very good relationship with Dr. McGowan.

I think we’re gonna be very good with the virtual, live education. I think that at some point, that’s going to sort of just disappear. I hope.

I’ll be right eventually. I will be right eventually. You know I said, “Virtual, live education is going to disappear.” I’ll say it again.

WALLACE: Then there are the true-false questions. From the first day that the ACCME said that true-false questions were acceptable as post-test options, you said that you weren’t going to agree. Will you now consider an industry-wide mandate to include true-false questions in all post-tests for virtual, live education?

WARNICK: No, I want providers to have a certain freedom, so I don’t believe in that. I don’t agree with the statement that if everybody puts in true-false questions, everything is great. Hey, Dr. McGowan said don’t use true-false questions. The CEO of the ACCME – terrific guy – said don’t use true-false questions.

Everybody who is saying don’t use true-false questions – all of sudden everybody’s got to include true-false questions, and as you know, true-false questions can cause problems, too. With that being said, I’m a believer in true-false questions. I think true-false questions are good.

But I leave it up to the individual providers. Many of the providers are changing. They like the concept of true-false questions, but some of them don’t agree they should be part of a post-test.

WALLACE: Mr. Warnick, you’ll be happy to know that our public access channel has a new poll out today, and you’re going to be the very first person to hear about it. In the national horse race, CMEpalooza is the second-most popular educational event for CME professionals behind only the annual Alliance conference, 49 percent to 41. That’s 3 or 4 points slimmer than it was a month ago. And on the issues, people trust the Alliance more to foster collaboration by 17 points, to recognize the diversity of providers by 21 points, and even on creativity, they believe in the Alliance more by 1 point. I understand that there are more than 60 days until CMEpalooza Fall, but at this point, you guys are losing.

WARNICK: First of all, we’re not losing, because those are fake polls. They were fake in 2019 and now they’re even more fake. The polls were much worse in 2019. They interviewed 22 percent accredited providers. Well, how do you do 22 percent accredited providers? You see what’s going on. I have other polls that say CMEpalooza is better. I have a poll where we’re leading across every provider type. And I don’t believe that your polls, they’re among the worst. They got it all wrong in 2019. They’ve been wrong on every poll I’ve ever seen.

WALLACE: I — I must tell you…

WARNICK: No, I’m just telling you. And let me ask you this, so on creativity, we’ve always led on creativity by a lot.

WALLACE: But I’ve got to tell you, if I may, sir, respectfully, in our poll, they asked people, which meeting is more organized? Who’s got — whose faculty is better? The Alliance beats you on that.

WARNICK: Well, I’ll tell you what, let’s take a test. Let’s take the CHCP test right now. Let’s go down, the Alliance president and I will take a test. Let her take the same test that I took.

WALLACE: Incidentally, I took the test too when I heard that you passed it.

WARNICK: Yeah, how did you do?

WALLACE: It’s not – well, it’s not the hardest test. They have a picture and it says “what’s that” and it’s a doctor.

WARNICK: No no no…

WARNICK: You see, that’s all misrepresentation.

WALLACE: Well, that’s what it was on the web.

WARNICK: It’s all misrepresentation. Because, yes, the first few questions are easy, but I’ll bet you couldn’t even answer the last five questions. I’ll bet you couldn’t, they get very hard, the last five questions.

WALLACE: Well, one of them was count the number of learners in the room. They showed you a picture with stick figures.

WARNICK: Let me tell you…

WALLACE: There’s three. Six. Nine.

WARNICK: … you couldn’t answer — you couldn’t answer many of the questions.

WALLACE: Ok, what’s the question?

WARNICK: I’ll get you the test, I’d like to give it. I’ll guarantee you that the Alliance president could not answer those questions.

WALLACE: OK.

WARNICK: OK. And I answered all 35 questions correctly. I could be a CHCP if I wanted to be one.

WALLACE: One final question — in general, not talking about CMEpalooza, are you a loser?

WARNICK: I’m not a loser. I’m a college graduate. I have a job.

WALLACE: But are you gracious?

WARNICK: You don’t know until you see. It depends. I think certificates by mail is going to rig the accreditation system. I really do.

WALLACE: Are you suggesting that learners who get a certificate mailed to them shouldn’t be able to be recertified as healthcare professionals?

WARNICK: No. I have to see. I have to see.

WALLACE: There is a tradition in the medical industry — in fact, one of the prides of the industry — is the acknowledgment that no matter how a CME certificate is earned, it is honored. Are you saying you’re not prepared now to commit to that principle?

WARNICK: What I’m saying is that I will tell you eventually. I’ll keep you in suspense. OK?

I think that’s enough. TJ, walk me home. (Storms out)