Is Free CE Really Free?

If you have ever channel surfed at odd hours or perused the offerings that sneak into our homes via the cable/dish superhighways, it is likely that you have encountered the dreaded “Infomercial.” This 30-minute commercial advertisement, disguised as an educational program, subjects you to the nearly subliminal juxtaposition of pseudoscientific facts, problems and, of course, the preferred solution. The testimonials are indeed powerful witness to the efficacy of the Gazelle, Tempurpedic Mattress, or Phase Four Orthotics. They would not keep doing this if it were not working.

Fortunately, the current environment for Continuing Dental Laboratory Education does NOT resemble this picture. I do, however, fear the baby steps I am observing that may be indicative of a morphological change in the delivery, support and intentional value of this important resource.

Ours is a noble “profession” not just an industry. We are charged to intentionally hold it’s ethical standards high and in the best interest of our doctors, patients and the profession. We must keep the patients’ best interests at the forefront of product, procedures and equipment decisions.

A concern is the growing commercialization of CE. It likely strikes you, as it does me, that lectures, presentations, materials, products and procedure support, or demonstrations that appear to be free or nearly free are too good to be true, unless they create benefit for the provider. Business partners, for-profit organizations, manufacturers, suppliers and purveyors of products and services likely provide substantial financial support that reduces the cost in part or whole. The price you pay for this convenience and affordability is being exposed to the promotion of the goods and services the financial supporters provide. Education that is biased toward what is in the best interest of the underwriters may not be what is in the best interest of the patient, lab technician or the dentistry.

Do not mishear me! Quality education can and often is provided by for-profit organizations and organizations financially supported by manufacturers and suppliers. I am stating that the profession needs to continue to be aware of the influence and understand that if something appears free of cost, it does not necessarily mean free of influence.  We can and should enjoy the support that vendors and manufacturers provide, but the message delivered should still be in the best interest of recipients, not morphed into a half-day infomercial for a product or procedure.

The accreditation bodies of the medical community have had to clamp down severely on Conflict of Interest and Financial Support and Disclosure issues. The new regulations (www.accme.org) have eliminated the granting of authorized CME credits for lucrative, all-expense paid junkets disguised as educational seminars, and strictly regulated the content influence of commercially supported programs (by the way, when am I going to be invited to one?).

There are even guidelines, now, that advise the pharmaceutical companies to delay advertising to the public and “pulling through” a drug product until it has been out six months. That is in direct response to the success of having each of us ask our doctors about, Cialis, the Purple Pill or Vioxx. Pfizer spent $667 million on just that type of advertising in 2004, and the top six pharmaceutical companies spent, in total, over $2 billion on advertising that year. I have written on this subject for the dental profession and now I will try to engage our profession of dental technology as well.

So how does it end? We are at an important time for our profession. The availability and scope of educational offerings has never been greater or more diverse. Commercially sponsored CE is more prolific than ever before and the pronouncement of “free” CE is appearing all over.  Are any of us naive enough to believe that anything of value is really free? The choices we make, as  continuous students with a license to learn, will in large part determine our continued professionalism and the communication of our expectations in regards to our leadership organizations.

Our CE, whether manufacturer sponsored, from a non profit or a for profit, institute, university, training program or other should have certain basic characteristics that focus it on the participant’s development and not just product or process sales.  The Mission of the NBC states, “The National Board for Certification administers the certification program which is the professional standard in dental laboratory technology. This program is the means for the dental profession, the dental laboratory industry and others interested in identifying dental technicians and dental laboratories that have demonstrated technical qualifications and personal commitment to maintaining the highest standards in dental technology.”  We should strive to strengthen the NBC’s role as oversight and integrity monitors for the plethora of offering that surround us.

Sponsorship and support are fine to be sure, but the balanced and fair representation of the evidence-based approach to information dissemination is of paramount importance.  CE programs that are simply product driven and do not offer alternative materials and procedures in their discussions are still valuable information, but may fall short of meeting the true “professional standard in dental laboratory technology’ as stated in our mission.  The development of the Certified Dental Technician as a professional member of the oral health care delivery team is an important attribute we should strive for.  The changing landscape in Dental Education and it’s service delivery will be best served by a collaborative team of professional men and women, acting the patient’s best interest.  General dentists, specialists, their staffs, and the CDT all invested in the common goal of doing what is in the best interest of the patient in an unbiased, scientifically sound milieu.
 Yogi Berra said, “If you come to a fork in the road, you ought to take it!” I hope this letter stimulates more dialogue. Open discussion on the merits of our current continuing educational accreditation process and the role of the NBC in certifying Technicians and Laboratories is healthy and will help this noble profession be sure of where it desires to go. After all, it does matter where.

Do you have a question for Mark Murphy? E-mail jdt@nadl.org.