Thursday, September 19, 2013

I Paid The ASA $360 For A Web Search. I Want My Money Back!

By now all you readers know about my disdain for the MOCA process for board recertification. But just because I don't like it doesn't mean I can just ignore it. I still have to comply with its rules to make sure I have a practice in ten years. In addition, California requires that I have at least fifty hours of CME every two years to maintain my medical license. Therefore, I use the ASA's Anesthesiology Continuing Education program (ACE) to keep up my CME hours.

I've been using ACE ever since I finished residency. It consists of two sets of question booklets, one issued in the spring, the other in the fall. It helps me reacquaint myself with all the information that I learned during training so many years ago. With it, I can receive sixty hours of credit each year. As a bonus, when I submit my answers back to the ASA, they automatically submit the hours I claimed for education to the ABA so I don't have to enter it manually into my MOCA portal. The price this year is $360 for ASA members ($830 for nonmembers) but has been going up steeply recently.

One good feature about ACE is that at the end of every question and answer, the author of that question lists the sources from which they obtained the information. While most of the sources are from reputable journals, I was disappointed that several questions in the latest booklet listed their sources as the medical wiki site UpToDate. Really? For those who aren't familiar with UpToDate, it is like Wikipedia for medical information. You see many of the medical students and residents using it to brush up on their knowledge of a particular subject before or after rounds. It certainly beats carrying all those pocket books that we used to cram into our lab coats, adding about twenty pounds to our weight.

However, for $360, I expect the ASA to use better references for their answers. Why should I pay that much money when I can do a simple web search myself to get the answers? Perhaps I'm asking for too much. Maybe it costs too much money to pay all those contributors to actually find the source article from which they derived their questions. Maybe the ASA needs to save their money for the new headquarters they are erecting in honor of themselves. Maybe the authors are so used to using UpToDate in their everyday practice that they have forgotten how to actually read a medical journal. Whatever the reason, I am sorely dissatisfied with the quality of this year's ACE. It is probably too late to change the questions for the fall booklet but maybe there is hope for 2014. Otherwise I can buy a lot of CME for that kind of money somewhere else.


  1. UpToDate a "wiki" site? I usually love your blog, but it seems you are unfamiliar with what UpToDate really is. Even the link you have should suggest the website is more than a simple wiki, stating UpToDate is used by "almost 90% of academic medical centers in the United States".

  2. I never said it isn't a popular source for information. I just expected more from the ASA for my money.

  3. Your characterization of UpToDate as a wiki site is pretty inaccurate. According to their site, they have something like 50 MDs on staff with 5,000 authors. They hand-search and review hundreds of journals to synthesize the content into topics and add graded recommendations. While I recognize your post is about ASA's CME, another reason for using UpToDate for my role is that every topic I read about in UpToDate is tracked for CMEs. Not quite the same as "a simple web search" or a "Wikipedia for medical information."