Yes indeed, ’tis the month of bags filled with mail from little boys and girls asking for that special something. Sadly, we were unable to get good old Saint Nick to help out with CMEpalooza’s special mailbox — our Ask Us Anything feature — so it’s up to the two of us (with some help from a few of our own elves) to calm your nerves, ease those holiday blues, and soothe your soul.
I will admit that, after turning over our usually overflowing mailbag, not much is left over for future months, so please, if you have an issue (professional or personal) you want us to help with, click here to submit your question(s). We’ll do our jolly best to give our usual helpful advice. Surely you have some family holiday angst you need us to referee.
Dear Derek and Scott,
In medical education workplaces, younger professionals often want to be heard (as they should), but it can feel like those of us with experience are being treated like relics instead of active contributors.
I’m in many groups where we are genuinely excited to bring in fresh perspectives, but lately I keep hearing the same phrase, “We don’t want to hear from the same old voices.” Cute at first… until you realize they mean you.
It seems as though the only way they feel they have a voice is to silence others. And guess what? If they keep accelerating the timeline for when someone becomes ‘old,’ they’re going to phase themselves out faster than a trend on TikTok.
How do we strike the balance between honoring experience and embracing new voices? How do we help these newbies understand that experience isn’t a nuisance to be cleared out but the foundation they’ll be standing on when the next shiny new crowd rolls in?
Huzzah,
Respectfully Seasoned
SCOTT: This is one of those age-old issues that is common among companies of any type and size. The youngins come in and want to establish their foothold by coming up with all sorts of great ideas in an effort to be heard and seen. The old guard wants to protect their place in the pecking order and make sure that their experience and knowledge is acknowledged appropriately. It’s one of those push and pull issues that everyone then gripes about to their significant others/friends/family over the weekend.
It sounds like you have a role in a variety of different groups, probably both personally and professionally. Your feelings are hurt, and rightly so, when you are no longer seen as bringing value to the team in favor of these newer voices.
From my experience, it comes down to having the right leader in place who can deftly both incorporate the, as you note, valuable and necessary input from new voices as well as that from seasoned (OK, fine, older) professionals. I have been within organizations and groups where there was poor leadership in place and this devolved into a really toxic “us vs. them” situation full of back-biting and unrest. But I have also been part of circumstances where the leader — be it the CEO/President or group leader — was skilled at striking the right balance to keep everyone happy and engaged.
Being this kind of leader isn’t something that is easily taught or learned (and frankly, it’s not a personal area of strength). You have to be a good listener, a quick thinker, and a skilled diplomat. You recognize when feelings are hurt and bring aggrieved parties together to hash out solutions before things cascade out of control. You consider personalities and life circumstances. You figure out ways to find connections between people of all ages and perspectives. And sometimes, yes, you make the hard decision to cut loose people who simply don’t want to play together in the same sandbox.
DEREK: One of the interesting aspects of being part of an industry-wide community is the diverse array of settings and environments that community members work in. What feels like a pressing issue to Person A might be something that Person B has never experienced. That doesn’t diminish the impact of the issue on Person A but perhaps adds perspective to how pervasive the issue may be community wide.
Personally, the issue of newbies pushing out old heads is not one I’ve had much experience with. In fact, if anything, I’ve had more trouble with the reverse situation. As producers and planners of a twice-yearly conference, Scott and I are constantly juggling the balance of seasoned faculty vs new voices. Without a doubt, it is the new voices that we have much more difficulty finding.
Outside of CMEpalooza, the workplace issues I have seen and experienced related to sharing of perspectives and opinions have revolved more around personality types than age. It’s the same old story of the more extroverted individuals dominating the discussion while the introverts wait for a break in the conversation (that never comes) to share their thoughts. The extroverts are annoyed at the introverts for not participating, and the introverts are annoyed at the extroverts for not giving them time to speak.
That is not the issue you are asking about, but I think the method of resolution is similar. When these types of conflicts arise, we all can benefit from a healthy dose of self-reflection and self-awareness. If you are upset with the new guard trying to drown you out or with the extroverts for failing to read the questions you submitted to the Zoom chat, take a moment to think about if there is anything you could personally do to improve the situation. Compromise is the key. Scott is right to point out the value of a good leader in these situations. A good leader will lead their team through a self-reflection process and work with both sides on a compromise.
Dear Derek and Scott,
Why do supporters issue RFPs at the end of the year if they’re only going to decline the applications citing a lack of funding?
Curiously,
Just Curious
DEREK: This is a little tricky to answer without additional context, but I’ll do the best I can.
“Lack of funds” does not mean “no funds.” Supporters do not issue RFPs without some budget dedicated to it. It’s possible that budget is small. It’s possible that budget is only enough for one grant. It’s possible that the application you submitted was really, really good — so good that it was ranked the second-best application received for the RFP., which, unfortunately, means there are not enough funds available to approve it. Thus, your application is declined for lack of funds.
Side note: You specifically mention RFPs at the end of the year, and I’m not quite sure what the relevance is here. Maybe I’m missing something. It is not uncommon for supporters to realize in Q4 that they have additional budget to use (there are a variety of reasons for this) and issue an RFP, but I don’t think that’s related to “lack of funds” rejections more than RFPs issued at other times of the year. Maybe Scott will correct me below.
SCOTT: I have a love-hate relationship with RFPs. They are good because they show that pharma company XYZ definitely has some money to spend in a specific therapeutic area on a specific topic and maybe even with a preferred format. They are bad because now everyone knows that pharma company XYZ definitely has some money to spend in a specific therapeutic area on a specific topic and there will be a mountain of grant submissions to compete with. I have anecdotally heard tales of supporters receiving upwards of 50 grants for one RFP (note from Derek: I can confirm this is accurate. I’ve received even more than that for one RFP.) Even if, for arguments sake, there are 3 “winning” grants, that means there are 47 losers. That’s a lot of organizations that get a decline email with a “lack of funding” rationale.
If you want to do some post-RFP research, it is usually possible to find a good number of the “winning” proposals, especially if they were tied to a specific conference. In earlier days, there was at least one pharma company that I am aware of that used to actually post the winning RFPs on their grant portal so everyone could see what was awarded and perhaps gain some insight into why that might have been the case. However, that hasn’t happened — at least that I am aware of — for many years.
I have a hard time believing that a pharma company would go through the time and effort to post an RFP and then not award any grant dollars to a “winning” proposal. I suppose it is possible if there are unforeseen circumstances, and funding that was initially earmarked for the RFP was pulled, but I would not think that is common. Yes, it can be frustrating to receive a cavalcade of “lack of funding” declines related to an RFP and there are most certainly dozens of other applicants grumbling right along with you, but that doesn’t mean that someone isn’t celebrating their “your funding application has been approved” email at the same time.
Dear Derek and Scott,
I think I already know the answer, but I’d appreciate your input.
Dr. B. Styles is an investor and on the Medical Advisory Board of his brother’s company, Styles Pharmaceuticals, which solely produces a CBD product for the treatment of insomnia. The CBD product has been clinically tested and registered with the FDA. Dr. Styles has disclosed this relationship to the CME provider in preparation for a presentation on pain management.
Although CBD has been clinically proven to aid in pain management, that’s not part of Styles Pharmaceuticals’ business line, nor does the company specifically promote CBD for pain management.
Does this relationship need to be mitigated? Should this relationship be disclosed to learners? Is there anything else we need to be worried about?
Back in the Saddle Again,
Disclosure Debbie
SCOTT: Just reading this question made me want to swallow a CBD gummy. So many variables, so many issues. And of course, since the question deals with the grey area of accreditation, I have no idea.
But this is where it pays to have friends, so I turned to the accreditation wizards behind our Fall 2025 “One Step Over the Line? What’s Right, What’s Wrong, and What Falls Into the Grey Area of Accredited CE” session to get their input. In a nutshell, here are their thoughts (if you aren’t an accreditation savant, you may want to pop a CBD gummy of your own right about now):
“Since the educational topic is pain management and Styles’ Pharmaceuticals’ business lines are related to insomnia — a completely different therapeutic area — Dr. B. Styles’ relationships are not relevant and do not require mitigation or disclosure under ACCME Standard 3 (see this Examples of Relevant Content document).
Nonetheless, we would advise Disclosure Debbie to have the presentation peer reviewed to confirm the following:
- This presentation is not related to insomnia in any way. Even if it not included within his submitted slides, it may be worth reaching out to Dr. B Styles to ask if a discussion of insomnia is part of his planned oral remarks. Clearly, it doesn’t seem far fetched that CBD could be discussed….for instance, if someone has pain, that can lead to insomnia…
- The presentation and its content meets the content validity expectations outlined in Standard 1 since Medical Marijuana and CBD are explicitly highlighted on the ACCME’s Website
- The presentation discloses any new and emerging trends, as well as the evidence level supporting any claims or conclusions
- The presentation meets content standards/requirements for all of your accrediting bodies (not just The Standards) since these may differ
But oh wise one, you said that the relationship wasn’t relevant to the content, why do I have to have it peer reviewed (essentially mitigating it)?? Well young padawan, if you are already having the content reviewed for content validity under Standard 1, you might as well have it reviewed for relevance too (and document it). This shows that you did your due diligence, especially if Styles Pharmaceuticals is a privately held company, which makes Dr. B Styles an ‘owner of an ineligible company’ and you are relying on the three exemptions under Standard 3.2 that permit him to be a presenting faculty member. Keep this documentation on hand for purposes of your self-study, PIP abstracts, audits, and the interview in case you need it.”
It may also be wise to assign a non-conflicted planner to monitor/moderate the session. This person can help ensure that Dr. Styles’ presentation and any follow-up discussions remain focused on the agreed-upon topics for the talk (ie, pain management). If the Q&A includes questions about sleep aspects of pain management, the planner can intervene to guide the conversation back to the approved topic, adding an extra layer of protection against any commercial bias.
Where our panelists differed is in their approach to Dr. Styles’ disclosure. Some felt it prudent to include his relationship and “over-disclose” to learners, letting them assess any potential conflict while others felt it was important only to disclose what their team had deemed relevant to the content. Like I said, grey areas.
Here are even some resources this crackerjack team suggested for you:
- Peer Review Form to validate content and relevance
- Compliance Check “When is a Financial Relationship Relevant?”
- Examples of related/unrelated content
I am sure that Derek has much, much more he’d like to add on this issue.
DEREK: [glances at nonexistent watch on his wrist]
Hoo boy, look at the time! I have so much I’d like to add here based on my accreditation experience as a CME Director 15 years ago, but with our word count approaching 2,500 words, I should probably wrap it up and save all that pent up wisdom for another AMA session. Too bad!
CMEPALOOZA 