LAST MONTH, I talked about becoming the best doctors we can be by staying current with the latest drops, drugs, devices and procedures available to assist healthcare consumers that trust us with their eye care. That column got me thinking about a related subject: As healthcare providers, how do we stay educated?

THE SYSTEM

When we look at the current system of CE, we find many players, each of whom impacts, in some manner, how we are educated.

The first of the players is us — those who take CE courses. In staying “educated,” one of our greatest challenges is time. With patient exams, human resource issues, social media postings and a host of other responsibilities (including paying the bills), where do we find the time to learn what we need to know to both run our businesses and provide quality care? We must also address the issue of increasing volume — that is, the amount of knowledge that we need to know expands significantly each year, regardless of our graduation year.

In addition to the CE course attendees, there are regulators. We are a legislated profession in which regulations — and the interpretation of those regulations — vary from state to state through individual boards vs. a unified federal set of laws. The result is that each state has a different set of CE requirements for which the providers of that state must abide. Of course, the state boards regulate; they do not provide CE.

The providers are people, like me, who share experiences and try to educate, motivate and entertain the course attendees. These educators are hired by another player in the system: the entities who develop, coordinate and administrate CE. These entities include local societies, state associations, regional meetings (controlled by various business entities) and national meetings (controlled by large socio-political organizations). Sprinkled in are industry-sponsored events (that are largely promotional education), private business entities (such as referral centers trying to woo referrals) and other third party businesses. Each entity has its own agenda.

Finally, there are those organizations that “approve CE” as being worthy of the credentials they decide to bestow upon the educators and the entities that provide that CE.

The entire system costs — and generates — a lot of money. Our profession produces a lot of meetings that provide and charge for CE. These events can be large financial drivers and, in some instances, the primary source of income for an entity.

ARE WE GOING THROUGH THE MOTIONS?

As one of the people who “gives the CE,” I often wonder, despite all the moving parts, are we really educating our profession, or just going through the motions so everyone can “get their hours?” In the typical CE course, many providers are active listeners who learn new ideas and skills. They take these ideas back to their practices and apply them to become better doctors. Yet, the audience also includes people who read the paper, use their phones, take a 15-minute break. . . or even a nap.

There are doctors who will say that it is none of someone else’s business whether they continue their education so long as they meet the requirements to practice. Others disagree and argue for more accountability. Both sides have a valid argument, and without their differences being settled, CE has evolved relatively little in the last 25 years.

IS IT TIME FOR RE-EVALUATION?

Maybe it is time our profession re-evaluate what CE is and what it should be, taking into account the various skill sets we really need, both as doctors and as business owners.

Consider that topics, such as “how to effectively communicate,” get coined as practice management when, arguably, they are the foundation of how doctors provide care. Learning how to appropriately describe and code for a service is considered business when, in reality, it is how we communicate what we did. In fact, in the future, as we continue to move toward value-based medicine, coding, documentation and communication may be even more important than the treatment itself.

Taking it a step further, where are we learning critical thinking skills, such as differential diagnosis? Where do we learn how to actually “care” for our patients as a whole, and not just as a single system entity? When do we continue to improve our skills for visual disease management?

It seems as if optics and contact lenses have been relegated to an afterthought when they are the solutions to most of our patients’ refractive diseases. For example, if I asked the average optometrist if inferior positive coma was more important to correct than superior inferior coma with a 6.0mm pupil, how would he or she answer?

TAKE A LOOK FROM A DIFFERENT PERSPECTIVE

More importantly, maybe it is time that we evaluate whether people are really learning, or only just getting credits. Some would argue that no one organization should have the right to decide what constitutes CE, the right to control who gives it or the right to regulate what people learn. Others would argue that someone must. Good points, but allow me to share a different perspective:

The one group of people who ultimately will be impacted by all of these issues is that group who visit our practices every day — our patients. Many have shown great interest in technologies, such as augmented reality, the Internet of things and social media. These technologies continue to make information more easily available — and will soon be able to diagnose conditions without the presence of a doctor, a situation that will challenge all health care professionals.

As consumer-driven diagnostic technologies, which can exist outside the walls of our practices, continue to develop and wear away at the fabric of what eye care is, knows, can or needs to do, we, as a profession, might consider putting aside our differences and the monetary influences that drive the CE industry, and figure it out before our educational future is dictated to us by Watson, Big Brother and the people who choose to seek care through the technologies currently waiting in the wings and in the vaults of entities that are not going to promote the advancement or existence of our current way of life.

Just an idea. OM