The association between community physician's attendance at a medical center's CME courses and their patient referrals to the medical center.

This study attempts to quantify an overall association between CME course attendance and referrals. Attendance at formal CME courses given by the University of Michigan Medical School and referrals to the University Hospitals were examined over a two-year period. Attendance and referrals were linked to physicians in Michigan identified through the Michigan Department of Licensing and Regulation and through the American Medical Association. For physicians who are office-based and likely to be in active practice (age less than 70), those who attended at least one of the University's CME courses referred more patients than those who did not attend one (means of 1.9 referrals per physician and 1.3 referrals per physician, p less than .001). The causal direction of the relationship is not clear, but probably operates in both directions. It is reasonable for medical center marketers to consider CME as an indirect method for marketing clinical services. It is also reasonable for CME directors to identify referring physicians as high-priority groups for marketing CME. Both marketing efforts may be significantly enhanced by linking data bases for referrals and for CME attendance. CME directors must also ensure that marketing efforts do not compromise the objectivity and integrity of the content of the institution's CME program.

Hospitals are high-stress employers.

Studies show that hospitals are particularly stressful employers, so hospital managers need to be more mindful of the symptoms of stress and coping techniques.