What Is Wrong With Continuing Medical Education?

A good friend in college in the National Speakers Association emailed me yesterday. In the back and forth of emails told me two things about the conference that she was attending:

1. She was beginning to see the frustrations of being in the continuing education (CME) market, and
2. She could not understand how such intelligent people (experts) could be so business stupid.

Now my friend has been in the speaking industry as a talent agent, a book agent, and as a professional speaker and trainer for more years than she will tell me. Her frustration arises from the fact that in the speaking industry we look at four benchmarks of proficiency:

1. Expertise – knowing your subject better than anyone in your audience.
2. Eloquence – having the skills and the preparation to relay that expertise from the platform.
3. Enterprise – having the business knowledge to convey expertise and eloquence without losing your shirt.
4. Ethics – having the professional self respect to do business in a morally correct fashion and not feel, coop, or plagiarize other people’s materials.

My friend’s email betrayed that she could not understand why all four benchmarks were missed in the CME arena.

I explained to her that it was not that the speakers she watched lacked expertise. It was that they lacked the eloquence to portray it. They used the same old jokes that they heard at the last four or five seminars very often, jokes that are not even relevant tangentially to the subject at hand. Alternatively, they will use a story whether it is heart wrenching, heart warming, scary, or reassuring even if it does not apply to the topic at hand. They will stretch and then over stretch to make a connection and in the process lose the audience and the entire point of their speech.

I explained to her that I am a devotee of AudioDigest (TM). AudioDigest (TM) is a recording service for medical seminars. Their editors listen to literally hundreds of speakers recorded at major CME programs around the world. They then have no trouble editing this down to the few that are worthy of audio reproduction. Even with that editorial review and relying on the grading of medical audiences, significant amounts of editing are required to produce useable audio seminars. An audioDigest program runs 55 to 60 minutes and very often has two speakers. I always have to remind my own speech students that each of these speakers were recorded at a 55 to 60 minute speech and yet very often it requires three of them edited to 20 minutes of useable information to create one 60minute audioDigest program. That means that each speaker wasted twothirds of their time and the audience’s time.

Speakers in the CME market are selected based on a written abstract. Almost never is a demonstration DVD required nor testimonials or prior review scores from previous appearances. When a CME committee selects a speaker, it is either political or based on their knowledge (expertise in the field). That committee has no idea of whether or not the speaker possesses any eloquence.

When it comes to enterprise, the old adage,

“Doctors do not know business”

rings truer than in any other endeavor. Medical speakers are very much like retired federal employees, they believe that a $500.00 speak use fee is a “homerun.” Beginning speakers charge greater than $1,500.00 with no expertise and little or no eloquence. In CME programs, all of the speakers have “terminal degrees.” They are doctors. They possess eight years or more of formal education and another three years or more of postgraduate training. Why are they charging the same amount as a college student or a construction worker turned speaker?

The reason is their expectation. They expect to get $500.00. I call this the “doughnut money” because most of these medical speakers got their first speaking engagement from a local drug rep that paid them out of the same budget that the drug rep uses to bring doughnuts to the doctor’s staff in the morning. These “doughnut money” speakers destroy the opportunity for enterprise in the CME market for more eloquent experts. This is why those of us who are professional speakers for a living simply do not speak in the CME arena. We ply our trade in more fervent pastures such as the corporate board room or high tech industry.

So if doctors have expertise but lack eloquence and enterprise, what about ethics? Aren’t doctors supposed to be the most ethical people? Don’t we trust them with decisions of life or death?

Physicians are on ethics committees in hospitals and make decisions regarding the appropriateness of each other’s care as well as weighing the risks and benefits of various treatments for various diseases. In these arenas, doctors are tremendously ethical.

Unfortunately when it comes to plagiarizing each other’s materials, “borrowing” comic strips, cartoons, and other artwork, even photographs, from copyrighted print material, playing music and even videos without royalty, even playing a recording of another speaker without their knowledge, doctors lack any form of professional speakers’ ethics. The speaking industry has a strict code of ethics regarding these activities and many others just as the medical profession has a code of ethics within their scope of practice. Those physicians that choose to live in both worlds choose to live by both codes of ethics and they must learn it.

My physician colleagues who speak for a hobby are not bad people. They are simply not educated in the speaking profession.

So what is the solution?

Just as physicians attend continuing medical education (CME), professional speakers attend continuing education dealing with the skills required to advance their Expertise, Eloquence, Enterprise and Ethics. My physician colleagues who choose to “dabble” in professional speaking should go to their local community college and take a speech course as well as creative writing course. If they took one in college, they need to take it again. Refreshers are always good. If they do not want to go to the community college, then they should join Toastmasters International.

This is an excellent opportunity for a new and burgeoning speakers to have their work critiqued (doctors fear critique) and a tremendous venue to try out new material. They do not have to be afraid of not knowing all the answers because their audience does not care what the message is, they do not care about the expertise. At Toastmasters International they care about the technique, it is the eloquence that matters.

If my physician colleagues do not want to join Toastmasters or go to a community college, then they should take an improve course at a local comedy club. Here they will learn stage presence, timing, pauses, joke writing, and finding the comedy in everyday life.

Through any one or all of these opportunities, the physician who “dabbles” in speaking can be as good on the platform as the family practitioner who “dabbles” in office surgery. They will be competent. They will be selfassured. They will have great outcome and they will know when they are getting in over their head. . . . When to ask for help.

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